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Low Vitamin D Levels Are Associated With Increased Risk of Musculoskeletal Injuries in Collegiate Athletes
Alexandra M Frank1, Mikel R Joachim1,2, Jennifer L Sanfilippo2,3
1Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin.
Background:
Vitamin (Vit.) D is an essential nutrient that is both synthesized by the body and supplemented via diet. Vit. D deficiency has been found to correlate with an increase in a variety of musculoskeletal injuries.
Hypothesis:
Lower levels of serum Vit. D would be associated with an increased number of musculoskeletal injuries in collegiate athletes.
Study Design:
Routinely collected data were reviewed for 284 student athletes at a Division I Big10 University.
Level Of Evidence:
Level 4.
Methods:
Serum 25-hydroxyvitamin D (25[OH]D) levels were obtained on athletes via chart review and classified as normal (≥32 ng/ml), insufficient (20-31 ng/ml) and deficient (≤19 ng/ml). Vit. D was analyzed both as a continuous variable and based on the 3-level classification. The odds of injury were estimated with mixed effects logistic regression models.
Results:
Results showed that 47.2% of athletes were Vit. D insufficient, with 17.6% being deficient. The odds of sustaining an injury at any point during the collection period were 13% higher for each 5 ng/ml decrease in the athlete's Vit. D level (odds ratio [OR], 1.13 (1.00-1.27); P = 0.05). There was no significant difference in injury time based upon Vit. D class. There was a significant negative correlation between Vit. D level and max jump height/max jump force (OR, -0.50 (-0.99, -0.02), P = 0.04; -0.20 (-0.37, -0.04), P = 0.01 respectively), which are clinically insignificant changes.
Conclusion:
Many collegiate athletes had insufficient or deficient Vit. D levels. Our results showed for each 5 ng/ml decrease in an athlete's Vit. D level, there was a 13% increase in odds of injury. Finally, there was no significant association between Vit. D level and athletic performance or injury recovery length.
Clinical Relevance:
Vit. D deficiency and insufficiency is highly prevalent in collegiate athletes.
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