Vitamin D Levels Related to Spine Bone Health

by | Apr 26, 2016 | 2015, Bone Health, Vitamin D - Bone Health

Written by Greg Arnold, DC, CSCS. The 246 study participants with spine fractures had vitamin D levels that were significantly lower (21.5%) than the 392 patient who had low back pain but without spine fractures. Also vitamin D levels in the summer months were 24.2% higher than in the winter months.

When it comes to the health dangers posed by osteoporosis, most attention is paid to hip fractures. By 2025, osteoporosis is expected to cause 3 million total fractures each year and $25.3 billion in healthcare costs (1). By 2050, half of all hip fractures are expected to be caused by osteoporosis (2).

Another significant area of concern regarding fractures in osteoporosis is that of fractures in the spine, specifically the bone in the spine called vertebrae. Vertebral fractures can decrease quality of life and increase risks of illness and death (3, 4). Regarding vitamin D’s importance in bone health, there is no universally accepted classification of vitamin D levels. The National Osteoporosis Society defines “deficiency” as less than 30 nmol/l (12 ng/ml), ”insufficiency” as 30 to 50 nmol/l (12 ng/ml to 20 ng/ml) = and “sufficiency” as greater than 50 nmol/ l (> 20 ng/ml) = adequate (5). Now a new study (6) suggests that vitamin D levels may play a role in spine fractures.

The study involved 246 patients (105 men, 141 women) between the ages of 57 and 86 admitted to a hospital in Germany with spine fractures. They had their vitamin D levels measured and compared to 392 patients (219 men, 173 women) between the ages of 52 and 73 admitted for low back pain and no spine fractures.

Researchers found “a significant difference” in vitamin D levels between the two groups. Specifically, those with spine fractures had 21.5% lower vitamin D levels vs. those without spine fractures (15.45 vs. 19.68 nanograms/milliliter, p = 0.036). Using the vitamin D level recommendations by the National Osteoporosis Society, 78% of those in the spine fracture group (191 patients) had vitamin D deficiency compared to 52% in the non-fracture group (203 patients, p = 0.032).   No significant differences were seen between males and females regarding vitamin D levels and spine fracture risk (p = 0.34).

In addition, the researchers observed “significant variations” in vitamin D levels between the summer and winter in all patients, regardless whether they had a spine fracture or not. Specifically, vitamin D levels during the summer months were 24.2% higher than the winter months (19.75 versus 15.9 ng/mL, p = 0.042).

For the researchers, “we have demonstrated a high frequency of vitamin D deficiency among patients presenting with vertebral fragility fractures. More than 80% of the patients were vitamin D insufficient, with values below the target range of 30 ng/ml to 60 ng/ml…given that two separate reviews have shown a > 20% risk reduction in non-vertebral fractures (7, 8), [maintaining healthy vitamin D levels] is important in this patient population.”

Source: Maier, G. S., et al. “The prevalence of vitamin D deficiency in patients with vertebral fragility fractures.” Bone Joint J 97.1 (2015): 89-93.

© 2015 The British Editorial Society of Bone & Joint Surgery doi:10.1302/0301-620X.97B1

Posted April 13, 2015.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY.  You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. “What Is Osteoporosis?” on the National Osteoporosis Foundation Website
  2. Gullberg, O. Johnell, and J. A. Kanis, “World-wide projections for hip fracture,” Osteoporosis International, vol. 7, no. 5, pp. 407–413, 1997b
  3. Lyles KW, Gold DT, Shipp KM, et al. Association of osteoporotic vertebral compression fractures with impaired functional status. Am J Med 1993;94:595–601.
  4. Evans AJ, Jensen ME, Kip KE, et al. Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate
  5. Aspray TJ, Bowring C, Fraser W, et al. National Osteoporosis Society Vitamin D Guideline Summary. Age Ageing 2014;43:592–595
  6. Maier GS. The prevalence of vitamin D deficiency in patients with vertebral fragility fractures. Bone Joint J 2015 Jan;97-B(1):89-93. doi: 10.1302/0301-620X.97B1.34558
  7. Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005;293:2257–2264.
  8. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007;370:657–666.