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Open AccessArticle

Prognostic Relevance of Circulating 25OHD Fractions for Early Recovery and Survival in Patients with Hip Fracture

1
Institute of Diagnostics, Faculty of Health Science, Szombathely Campus, University of Pecs, 14 Jókai Street, H-9700 Szombathely, Hungary
2
Department of Traumatology, Markusovszky University Teaching Hospital, 5 Markusovszky Street, H-9700 Szombathely, Hungary
3
School of Medicine, Institutes of Laboratory Medicine and Neurology, University of Pecs, 13 Ifjuság Street-floor 7, H-7624 Pécs, Hungary
4
Molecular Pathology, Markusovszky University Teaching Hospital, 5 Markusovszky Street, H-9700 Szombathely, Hungary
5
Department of General Internal Medicine, Markusovszky University Teaching Hospital, 5 Markusovszky Street, H-9700 Szombathely, Hungary
6
Department of Radiology, Markusovszky University Teaching Hospital, 5 Markusovszky Street, H-9700 Szombathely, Hungary
*
Author to whom correspondence should be addressed.
This paper is dedicated to the 650th anniversary of the University of Pecs.
J. Clin. Med. 2018, 7(8), 193; https://doi.org/10.3390/jcm7080193
Received: 30 June 2018 / Revised: 28 July 2018 / Accepted: 28 July 2018 / Published: 1 August 2018
(This article belongs to the Section Orthopedics)
The relation between vitamin-D (VD) status and healing after hip fracture had not been sufficiently addressed. Currently serum total 25-hydroxy-VD (t-25OHD) is the most widely used indicator of VD status. It is unclear whether free or bioavailable VD are better markers of 25OHD availability for tissues. Validity of overall cut-off values of t-25OHD is limited. Objectives: (1) Assess serum levels of circulating forms of 25OHD in patients with hip fracture (PwHF: N = 199) compared to active controls without history of fracture (N = 102); (2) determine relationship between 25OHD fractions and functional performance after surgery (FPAS) and survival. The t-25OHD; VD binding protein and albumin levels were measured. Comorbidities; lifestyle; FPAS and survival were recorded at seven months. VD deficiency occurred more frequently in PwHF than in controls (72% vs. 38%). Patients with better FPAS showed higher 25OHD in all fractions than with poor FPAS. Controlled by lifestyle; 25OHD levels were independent predictive factors (p < 0.001). Good FPAS values forecasted longer survival (OR: 6.5CI:3.2–13.3; p < 0.0001). All 25OHD forms showed a tendency to predict survival. Mortality rate decreased to 8% in individuals with t-25OHD levels of >22.6–39.5 nmol/L and increased to 14% with >40 nmol/L. These observations highlight the importance of serum 25OHD assessment and moderate VD substitution for healing and survival. View Full-Text
Keywords: total-25OHD; bioavailable-25OHD; free-25OHD; cut off values; hip fracture; comorbidities; healing; survival total-25OHD; bioavailable-25OHD; free-25OHD; cut off values; hip fracture; comorbidities; healing; survival
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Toldy, E.; Salamon, A.; Kálmán, B.; Ágota, K.; Horváth, D.; Lőcsei, Z. Prognostic Relevance of Circulating 25OHD Fractions for Early Recovery and Survival in Patients with Hip Fracture. J. Clin. Med. 2018, 7, 193.

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