Hypovitaminosis D and ‘functional hypoparathyroidism’—the NoNoF (Nottingham Neck of Femur) study

Background: calcium and vitamin D deficiency are common in elderly people and lead to increased bone loss, with an enhanced risk of osteoporotic fractures. Although hip fractures are a serious consequence, few therapeutic measures are given for primary or secondary prevention. A combination of calcium and vitamin D may not be the most effective treatment for all patients. Objective: to investigate the effects of hypovitaminosis D on the calcium–parathyroid hormone endocrine axis, bone mineral density and fracture type, and the optimal role of combination calcium and vitamin D therapy after hip fracture in elderly patients. Design: a population‐based, prospective cohort study. Methods: 150 elderly subjects were recruited from the fast‐track orthogeriatric rehabilitation ward within 7 days of surgery for hip fracture. This ward accepts people who live at home and are independent in activities of daily living. All subjects had a baseline medical examination, biochemical tests (parathyroid hormone, 25‐hydroxyvitamin D and 1,25‐dihydroxyvitamin D) and were referred for bone densitometry. Results: at 68%, the prevalence of hypovitaminosis D (25‐hydroxyvitamin D