A meta-analysis of 25 hydroxyvitamin D in older people with fracture of the proximal femur

Aims. To perform a meta-analysis on the published studies of serum levels o f 25 hydroxyvitamin D in older people with fractures of the proximal femur compared to control groups. Methods. A 'Medline' literature search using key words 'vitamin D' and 'hip fractures' for the years January 1966 to June 1999, seeking only papers pu blished in English and available from New Zealand medical libraries, was pe rformed.: Bibliographies of identified papers were also searched. Studies w hich compared 25 hydroxyvitamin D levels in people with a fracture of the p roximal femur to an older control group were eligible for inclusion. 30 stu dies were identified and 28 papers could be found in New Zealand. The metho d of weighted Z statistics was used in the meta-analysis. Results. The pooled reduction in serum 25 hydroxyvitamin D for the fracture group compared to the controls was 0.66 of a standard deviation with a 95% confidence interval of 0.74 to 0.59. Conclusions. Although there may be publication bias in this meta-analysis a nd there was some evidence of heterogeneity in the studies, there is very g ood evidence that older people with fracture of the proximal femur have red uced levels of vitamin D compared to controls. Older people with fracture o f the proximal femur should be treated with vitamin D.