Histomorphometric analysis of patients with femoral neck fracture and 25-hydroxyvitamin D deficiency: a cross-sectional study

• Published in: Journal of bone and mineral metabolism 2024-03, Vol.42 (2), p.214-222
• Main Authors: Okumura, Go, Yamamoto, Noriaki, Suzuki, Hayato, Ninomiya, Hiroshi, Hirano, Yuki, Tei, Yoshiaki, Tomiyama, Yasuyuki, Shimakura, Taketoshi, Takahashi, Hideaki E., Imai, Norio, Kawashima, Hiroyuki
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Bone Density; Bone histomorphometry; Bone surgery; Calcifediol; Cross-Sectional Studies; Femoral Neck Fractures; Femur; Femur Head - pathology; Fractures; Humans; Medicine; Medicine & Public Health; Metabolic Diseases; Mineralization; Original Article; Orthopedics; Osteoid; Osteomalacia; Osteomalacia - pathology; Osteoporosis; Patients; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D Deficiency - complications; Vitamin deficiency
• ISSN: 0914-8779; 1435-5604; 1435-5604
• DOI: 10.1007/s00774-024-01495-6

Introduction Vitamin D deficiency causes osteoporosis, bone mineralization disorders, and osteomalacia. Osteomalacia is diagnosed using blood biochemical tests, clinical symptoms, and imaging; however, accurate detection of mineralization disorders requires tissue observation. We investigated the prevalence of bone mineralization disorders and their relationship with serum 25-hydroxyvitamin D (25OHD) levels in patients with untreated osteoporosis with femoral neck fractures. Materials and methods A non-demineralized specimen was prepared from the femoral head removed during surgery in 65 patients. Bone histomorphometry of cancerous bone in the femoral head center was conducted. Osteoid volume per bone volume (OV/BV) and osteoid thickness (O.Th) were measured as indicators of mineralization disorder. Results The mean serum 25OHD level (11.9 ± 5.7 ng/mL) was in the deficiency range ( 10% and O.Th > 12.5 µm); however, one case of mineralization disorder, considered histologically pre-osteomalacia (OV/BV > 5% and O.Th