髋部骨折是严重影响患者生活质量和健康的主要健康问题。这在老年受试者中尤为明显,其中骨骼和肌肉质量的下降并存,并使个体容易跌倒和骨折。在髋部骨折患者实施的干预措施中,营养状况的评估和管理至关重要,尤其是65岁以上的受试者。营养在骨折的一级和二级预防中起着核心作用。充足的蛋白质摄入可改善肌肉质量和力量以及肠道对钙的吸收。对骨骼健康具有公认有益作用的其他营养素是钙,维生素D,K,C,钾,镁,叶酸,和类胡萝卜素。关于钙,纵向研究的结果表明,食用乳制品对骨折有保护作用。此外,最近的系统评价和荟萃分析以及一项综合评价表明,钙和维生素D补充剂的组合显着降低了髋部骨折的风险,在年龄较大和制度化的受试者中具有更高的疗效。由于这些原因,充足的钙摄入量,维生素D,蛋白质,和其他宏观和微量营养素已成功实施的骨折联络服务(FLSs),代表了最可靠的模式的髋部骨折患者的管理。在这篇叙述性评论中,论文(随机对照试验,前瞻性和干预性研究,和系统综述)通过三个不同数据库(PubMed,Embase,和Medline)已经进行了分析,以及筛查的现有信息,评估,介绍了髋部骨折患者的营养和维生素D状态以及钙摄入的管理以及具体的预防和治疗措施。
Hip fractures are a major health issue considerably impacting patients\' quality of life and well-being. This is particularly evident in elderly subjects, in which the decline in bone and muscle mass coexists and predisposes individuals to fall and fracture. Among interventions to be implemented in hip fractured patients, the assessment and management of nutritional status is pivotal, particularly in subjects older than 65. Nutrition plays a central role in both primary and secondary preventions of fracture. An adequate protein intake improves muscle mass and strength and the intestinal absorption of calcium. Other nutrients with recognized beneficial effects on bone health are calcium, vitamins D, K, and C, potassium, magnesium, folate, and carotenoids. With reference to calcium, results from longitudinal studies showed that the consumption of dairy foods has a protective role against fractures. Moreover, the most recent systematic reviews and meta-analyses and one umbrella review demonstrated that the combination of calcium and vitamin D supplementation significantly reduces hip fracture risk, with presumed higher efficacy in older and institutionalized subjects. Owing to these reasons, the adequate intake of calcium, vitamin D, protein, and other macro and micronutrients has been successfully implemented in the Fracture Liaison Services (FLSs) that represent the most reliable model of management for hip fracture patients. In this narrative review, papers (randomized controlled trials, prospective and intervention studies, and systematic reviews) retrieved by records from three different databases (PubMed, Embase, and Medline) have been analyzed, and the available information on the screening, assessment, and management of nutritional and vitamin D status and calcium intake in patients with hip fractures is presented along with specific prevention and treatment measures.