Vitamin D depletion associated with low bone density due to burns




Journal of Trauma

Related Monographs

Consumer Data: Vitamin D Burns
Professional Data: Vitamin D Burns


Burns have a number of causes, including thermal agents, ultraviolet light radiation, chemicals, and electricity. Burn damage in the skin causes cellular death, capillary injury, and coagulation of protein. Capillary injury is manifested by increased capillary permeability, resulting in a wet or weepy appearance of second and third degree burns.

Major burns require emergency treatment at a local hospital followed by transport to a regional burn facility for specialized definitive care. Infection secondary to burns can be dangerous and difficult to treat because the burned skin provides an excellent growth medium for bacteria. Also, the burned tissue hampers the effective delivery of systemic antibiotics. The risk of complications increases as the severity of the burn increases. The more deeply the skin layers are damaged, the greater the body's natural defense mechanisms are compromised, increasing the possibilities of skin infection, systemic infection, fluid and electrolyte loss, and shock, which can cause death.

Children burned over 40% of their body have chronically lower bone mineral density, which leads to an increased risk of osteopenia as well as osteoporosis. One hypothesis published in the Journal of Trauma stated that the lack of vitamin D that contributes to lower bone mineral density is because the children cannot be in direct sunlight or hyperpigmentation will occur to the burn scars. The researchers examined 24 children, ages ranging from 5 to 20 years. All children involved were burned over 40% of their bodies. Half of these children received human growth hormone the year following the burn injuries. Researchers measured the bone mineral density of the spine and the levels of vitamin D in all the children. Serum levels of vitamin D were low in the majority of the children at 7 years post burn. Osteocalcin was low at 2 years post burn. The vitamin D levels correlated to the bone mineral density scores. The authors concluded that, " Burned children have low circulating levels of 25(OH)D which correlated with BMD z-scores, suggesting that post-burn vitamin D depletion may play a role in the chronically low bone density observed in these children."1


1. Gordon L. Klein, et al. Vitamin D Depletion following Burn Injury in Children: A Possible Factor in Post-Burn Osteopenia. JOURNAL OF TRAUMA. Mar 2002;52:346-350.