ORIGINAL ARTICLE Hip fracture patients in India have vitamin D deficiency and secondary hyperparathyroidism D. K. Dhanwal & S. Sahoo & V. K. Gautam & R. Saha Received: 11 August 2011 / Accepted: 30 March 2012 / Published online: 28 April 2012 # International Osteoporosis Foundation and National Osteoporosis Foundation 2012 Abstract Summary This study evaluated the parameters of bone min- eral homeostasis including 25(OH)D and PTH in 90 Indian patients with hip fracture and 90 controls. Hypovitaminosis D, secondary hyperparathyroidism, and biochemical osteo- malacia was present in 77, 69, and 50 % patients, respec- tively, significantly higher compared to controls. Vitamin D deficiency is an important risk factor for hip fracture. Introduction The prevalence of vitamin D deficiency is not well known in hip fracture patients from India. Therefore, the present study was conducted to evaluate the parameters of bone mineral homeostasis including 25(OH)D and intact PTH in hip fracture from North India. Methods Ninety consecutive patients with hip fracture and similar number of age- and sex-matched controls were en- rolled in the study. The fasting venous samples were analyzed for 25-hydroxyvitamin D (25-OHD), intact para- thyroid hormone (PTH), alkaline phosphatase (ALP), calci- um, and phosphorus. Vitamin D deficiency was defined as serum 25-OHD of <20 ng/dl. Results The mean age of hip fracture subjects was 65.9± 12.6 which was comparable in men and women. Majority of study subjects were women (70 women and 20 men). The serum 25(OH)D and calcium levels were significantly low- er, whereas the intact PTH and ALP levels were significant- ly higher in patients compared to controls. There was significant negative correlation between serum 25(OH)D and PTH. In the hip fracture group, 76.7 % of the subjects had vitamin D deficiency, and 68.9 % had secondary hyper- parathyroidism. In the control group, vitamin D deficiency and elevated PTH levels were seen in 32.3 and 42.2 %, respectively. Conclusion About three fourths of hip fracture patients have vitamin D deficiency, and two thirds have secondary hyper- parathyroidism. Therefore, the serum 25-OHD level may be a useful index for the assessment of risk of hip fracture in India. Keywords Hip fracture . Hypovitaminosis D . India . Intact PTH . 25-OHD . Vitamin D deficiency Introduction Osteoporosis is a major health problem especially in elderly populations and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both mor- bidity and mortality in the elderly. The demographics of world populations are set to change with more elderly living in developing countries and it has been estimated that by 2050 half of all hip fractures worldwide will occur in Asia Recipient of the Young Investigator Award during the IOF Regionals, First Asia-Pacific Osteoporosis Meeting held in Singapore in December 2010. D. K. Dhanwal (*) : S. Sahoo Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant Hospital and Guru Nanak Eye Centre, New Delhi, India 110002 e-mail: dineshdhanwal@hotmail.com V. K. Gautam Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant Hospital and Guru Nanak Eye Centre, New Delhi, India 110002 R. Saha Department of Biostatistics, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant Hospital and Guru Nanak Eye Centre, New Delhi, India 110002 Osteoporos Int (2013) 24:553–557 DOI 10.1007/s00198-012-1993-y