Issue: 2015 > March > original article

Prevalence and correction of severe hypovitaminosis D in patients over 50 years with a low-energy fracture

E-J. ter Bor, W. van den Hoeven-van Kasteel, J.C. Kelder, W.F. Lems
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Purpose/Introduction: To examine the increase in serum 25(OH) vitamin D levels after supplementation with 800 IU/day of vitamin D in patients with low vitamin D levels and which factors affected the increase in vitamin D levels. Methods: The study included patients > 50 years with a low-energy fracture and a vitamin D level < 30 nmol/l. This was a retrospective study and was carried out at a large non-teaching hospital in the Netherlands. Results: 82 patients were included, mean basal 25(OH) vitamin D level was 21.2 nmol/l. After a mean of 9.8 weeks, the mean increase in vitamin D was 48.5 nmol/l. Only 45.1% reached the target level of > 50 nmol/l. The increase was correlated with the basal level of vitamin D (p < 0.05), and the time interval between the two vitamin D measurements (p < 0.05) and was inversely related to body weight (p < 0.05), but was not related to age, gender or renal function. Conclusions: We found that the generally recommended dosage of 800 IU of vitamin D per day resulted in suboptimal serum levels after ten weeks of treatment in more than half of the patients. The increase in vitamin D levels was higher in patients with low body weight and in patients with very low basal vitamin D levels. These data suggest that these patients should initially be treated with higher dosages of vitamin D. If not possible, vitamin D measurements should be performed after at least six months of supplementation with dosage adjustment.