The relationship between the concentrations of markers of bone remodeling in patients with rheumatoid arthritis and osteoporosis

Objective: To identify the risk factors of vitamin D inadequacy and to investigate the prevalence and mean of vitamin D inadequacy in patients with fragility hip fracture at Police General Hospital, Thailand.Methods: A case-control, single-center study was conducted in 274 patients who were at least 50 y of age, presented with a hip fracture caused by a low energy injury and were admitted to Police General Hospital from April 1, 2014 to April 30, 2018.Patients were divided into 3 groups according to serum 25(OH) D level.Demographic data and factors associated with vitamin D inadequacy were analyzed.Results: Among 258 patients with a hip fracture included for analysis, the majority of them (74.81%) were female.The average age of patients was 78.76 years old.While the mean of vitamin D level was 19.64 ng/ml, the prevalence of vitamin D inadequacy was 86.05%, consisting of vitamin D insufficiency (28.69%) and vitamin D deficiency (57.38%).BMI ≥23 kg/m 2 and fall ≥2 times were found to be the associated risk factors for vitamin D inadequacy.Meanwhile, the factors associated with vitamin D deficiency include female gender, BMI ≥23 kg/m 2 , fall ≥2 times and serum PTH level >65 pg/ml. Conclusion:Patients with fragility hip fractures had lower vitamin D levels and a higher prevalence of vitamin D inadequacy compared to that of the healthy Thai population.Serum 25(OH)D level examination and vitamin D supplement are recommended in this patient group, especially those with risk factors, i.e., female gender, obesity and high risk for falling.P438