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TABLE 4-10 Serum 25OHD Levels and Fractures in Postmenopausal Women and Older Men: Summary from AHRQ-Ottawa Analysesa



Population Description

Duration (or Matching Variables)

Bone Health Outcomes

Covariates; Summary of Results

Prospective cohort studies

Cummings et al., 1998

Subset of a cohort of ambulatory community-dwelling women ≥ 65 years of age (nested case–control study); 72.6 y (subset)

5.9 y

Hip fractures

Adjusted for age, weight, and calcaneal BMD (SPA)




There were no statistically significant unadjusted or adjusted (age, weight, season, use of vit D supplements) associations between serum 25OHD or PTH and the risk of hip or vertebral fracture

United States


Vertebral fractures



BMD calcaneus (SPA)

For women in the lowest quintile of serum 25OHD levels, there was no increased risk for hip or vertebral fracture


n = 9,704







Women in the lowest quintile of serum 1,25(OH)2D had a significant increase in hip fracture risk (RR 2.1, 95% CI 1.2–3.5), but not vertebral fracture risk





Gerdhem et al., 2005

Ambulatory independently living women, 75 y (range 75–75.9 y)

3 y

Fractures (low energy)

119/986 (12%) had a total of 159 low-energy fractures (29 hip, 28 wrist, 12 proximal humerus, 43 vertebral, and 47 other)





9/43 (21%) with 25OHD < 50 nmol/L had one or more fractures vs. 110/943 (12%) with 25OHD > 50 nmol/L: HR 2.04 (95% CI 1.04–4.04)


n = 1,044







Fracture association was independent of season, although a seasonal difference was noted in mean level of 25OHD (September 101 nmol/L vs. February 89.8 nmol/L)

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