Introduction: Mounting evidence suggests that vitamin D deficiency could be linked to several chronic diseases. The overall prevalence of vitamin D deficiency is 41.6%. Patients with low vitamin D often sustain compression fractures secondary to osteopenia and osteoporosis. In addition, testosterone deficiency is known to be a leading cause of male osteoporosis. Trials have shown that males with testosterone deficiency sustain spine fractures more frequently. No research to date has investigated the incidence of hypovitaminosis D in patients 18-60 who have sustained a spine fracture. The purpose of this investigation is to determine the incidence of hypovitaminosis D and testosterone deficiency in males aged 18-60 that have sustained a spine fracture of at least one vertebral body secondary to known trauma.
Methods: This retrospective study reviews vitamin D and testosterone levels of 227 patients presenting to a level 1 trauma center with a vertebral body fracture over a three year period. Simple point estimates were obtained to determine sample incidence of testosterone deficiency and hypovitaminosis D. Chi-square tests were used to compare percentages among independent patient groups.
Results: Overall incidence of hypovitaminosis D and low testosterone is 72.0% and 74.7% respectively in the study population. Previously reported data has shown that the average prevalence of hypovitaminosis D in the male population is about 40%, which falls significantly below our confidence interval. Results indicate that patients ages 18-30 have greater incidence of deficiency of Vitamin D while those ages 31-45 have greater deficiency in testosterone.
Conclusions: The results indicate that patients presenting with traumatic spine fractures have an increased incidence of hypovitaminosis D and hypoandrogenism. There is a statistically significant correlation between hypovitaminosis D and low testosterone with traumatic spine fractures. The results also indicate that these correlations exist across the board with no statistically significant preference for age group or vertebral column region.
Patient Care: This research investigation reveals a correlation between a hypovitaminosis D and hypoadrogenism with spine fractures in otherwise health male patients. Identifying this risk factor has the potential to impact preventive care as well as initiate further research into the healing process for these patients.
Learning Objectives: Participates should be able to:
1) Identify spine fracture patients that are likely to be low in vitamin D and/or testosterone
2) Identify an additional metabolic risk factor for the development of spine fractures in male patients
3) Recognize age associations with metabolic deficiencies related to vitamin D and testosterone as it relates to male patients with traumatic spine fractures