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Vitamin D insufficiency and fracture risk

Glowacki, Juliea; LeBoff, Meryl Sb

Current Opinion in Endocrinology & Diabetes: December 2004 - Volume 11 - Issue 6 - p 353-358
doi: 10.1097/
Parathyroids, bone, and mineral metabolism

Purpose of review Evidence has accumulated to show the prevalence of vitamin D insufficiency and deficiency in all age groups. Inadequate exposure to sunlight and to dietary sources contribute to the reemergence of musculoskeletal problems attributable to hypovitaminosis D.

Recent findings There is a growing body of evidence for the alarming prevalence of vitamin D insufficiency and deficiency among healthy adolescents, adults, and elders. Several studies show increased prevalence of vitamin D deficiency among patients with fractures and patients with persistent musculoskeletal pain. Evidence suggests that genetic variations in the vitamin D receptor are associated with fracture risk. There has been a reconsideration of the range of normal laboratory values and recommended daily intake of vitamin D for different groups of individuals. New strategies are needed to identify individuals who would benefit from vitamin D treatments. Identification of vitamin D deficiency in patients with fractures and its correction require the education and cooperation of multiple specialists.

Summary Physicians and orthopedic surgeons need to be alert to populations at risk of hypovitaminosis D. Immediate correction and maintenance of vitamin D adequacy require interactions of medical specialists.

aDepartment of Orthopedic Surgery, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA; bDepartment of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA

The authors’ work on vitamin D has been supported by grants from the United States Department of Defense.

Correspondence to Julie Glowacki, PhD, Orthopedic Research, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA

Tel: 617 732 5397; fax: 617 732 6937; e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.