Low Vitamin D Levels in Children with Fractures: a Comparative Cohort Study

Peter D. Fabricant, Christopher J. Dy, Son H. McLaren, Ryan C. Rauck, Lisa S. Ipp, Shevaun M. Doyle

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: The currently accepted ranges for “normal” serum vitamin D have recently been challenged in adults on the basis that healthy bone metabolism requires higher levels of vitamin D than previously thought. Purpose: The purpose of this study was to evaluate whether a new “biologically based” classification based on 25(OH)vitamin D levels that invoke an endocrine biomarker response (<20 ng/mL for deficiency and <32 ng/mL for insufficiency) is more appropriate for children with fractures than historical criteria. Methods: Serum 25(OH)vitamin D levels were collected from 58 children with acute low-energy fractures from an outpatient orthopedic clinic from 2009 to 2012. These vitamin D levels were compared with a cohort of 103 children with chronic kidney disease (CKD) from an adjacent clinic, a condition with acknowledged low levels of vitamin D. Then, the prevalence of vitamin D sufficiency in the fracture cohort was evaluated and compared using both historical guidelines and newer biologically based criteria. Results: 25(OH)vitamin D levels in the fracture cohort did not differ from levels in the CKD cohort (27.5 vs. 24.6 ng/mL) indicating a similar distribution of vitamin D levels. This finding was consistent when controlling for significant covariables using linear regression analyses. In the fracture cohort, there was a discrepancy between historical and biologically based criteria in 64% of children. Conclusions: The results of the current study suggest that fracture patients are more frequently vitamin D deficient than previously thought. This finding is more readily apparent when newer biologically based criteria for vitamin D sufficiency are used.

Original languageEnglish
Pages (from-to)249-257
Number of pages9
JournalHSS Journal
Issue number3
StatePublished - Oct 1 2015


  • BMI
  • calcium
  • deficiency
  • fracture
  • insufficiency


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