DMSci. Research Center of Ageing and Osteoporosis, Department of Medicine, 2600 Glostrup.
Abstract:
Aim: To determine the association between all-cause mortality and serum levels of 25(OH)D in hip fracture patients (HF) and a background population.
Design and setting: We conducted a retrospective, observational cohort study.
Participants: 562 HF patients and 247,574 controls.
Main Outcome Measures: Multivariate Cox regression analysis was used to compute hazard ratios for all-cause mortality.
Results: 151 of 562 (26.8%) HF patients died, 1-year mortality: Female 24.6% and males 33.3%, p < 0.0001 (log rank). Among the HF patients 86 (15.3%) suffered secondary hyperparathyroidism (SHPT), 1-year mortality 34.9%.
Background Population: 15.198 (6.1%) died. 2.3% suffered SHPT, 1-year mortality of 10.3%. A serum 25(OH)D level of 50–60 nmol/L was associated with the lowest mortality risk. Compared to 50 nmol/L, the hazard ratios (95% confidence intervals) of all-cause mortality at very low (10 nmol/L) and high (140 nmol/L) serum levels of 25(OH)D were 2.13 (2.02–2.24) and 1.42 (1.31–1.53), respectively.
Conclusion: Our observations shows that SHPT is significantly associated with mortality in both hip fracture patients and in the general population. The prevalence of SHPT is significantly higher among HF patients compared to controls. A reverse J-shaped relation between serum level of 25(OH)D and all-cause mortality was observed.
