Changes of biochemical markers during fracture healing

Abstract

The aim of this study was to evaluate the changes of biochemical markers during fracture healing in patients with osteoporosis. The study included 26 patients; 9 underwent hip hemiarthroplasty (mean age +/- SD: 71.0 +/- 10.2 years, group EN) for femoral neck fractures. 7 underwent osteosynthesis (75.3 +/- 8.2 years, group OS) for trochanteric fractures, and 10 subjects had spinal compression fractures (68.2 +/- 12.0 years, group CO). No operative procedures were performed in group CO. Urinary pyridinoline (Pyr), deoxypyridinoline (Dpyr) by high performance liquid chromatography (HPLC), Crosslaps by both enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) (CTx-ELISA and CTx-RIA) and serum N-terminal mid-fragment osteocalcin (OCN-Mid) by ELISA were analyzed at the time of admission and at weeks 1, 2, 4, 8 and 24 after operation or, in the case of group CO, after admission. As a whole, bone resorption markers started to increase from week 1, with various peak values between weeks 4 and 8 depending upon the particular marker, but returned to the initial vales at week 24. OCN-Mid started to increase from week 8 and remained at elevated levels at week 24. In groups EN and OS, bone resorption markers changed in the same manner as they did as a whole group. OCN-Mid did not change in group EN, although it increased significantly from week 8 in group OS. No biochemical markers changed significantly in group CO. In conclusion, bone resorption was accelerated at an early stage due to acute osteonecrosis or bed rest, followed by bone formation due to callus or mechanical stress later on. As far as bone resorption markers are concerned, 24 weeks are enough to eliminate the effect of fracture.

Ankaferd Blood Stopper: Does it have a role in fracture healing?

“…All of these serum markers increased or decreased after different skeletal bone fractures and fluctuated during fracture healing in agreement with the literature data (14,(24)(25)(26). For example, OC elevated at 24 weeks after fracture of the tibial shaft and rose at 1 week after distal radial fracture.…”

“…PYD-DPYD peaks 1 to 8 weeks after proximal femoral fracture, and PYD peaks 1 to 4 weeks after fracture of the tibial shaft. PYD is a less specific marker of bone resorption than DPYD since it is abundant in all connective tissues; however, DPYD is distributed generally in bone and dentin, and 90% of the bone matrix consists of type I collagen (14,26). In the present study, no significant changes were observed for the markers of bone formation and resorption analyzed between the groups.…”

“…Markers of bone formation (e.g., alkaline phosphatase [ALP], osteocalcin [OC]) and resorption (e.g., pyridinoline [PYD], deoxypyridinoline [DPYD]) reflect the overall osteoblastic and osteoclastic activity in the skeleton (14,15). As biomarkers of bone turnover, they clinically provide useful evidence of the normal and pathologic processes reflecting bone metabolism or cell activity in the bone tissues (16).…”

Sequential Changes of Bone Metabolism in Normal and Delayed Union of the Spine

“…started to increase 2 weeks after fracture, and values at 48 weeks were still higher than the initial values. This pattern of changes in bone resorption and formation markers was mostly consistent in the case of hip fracture [21].…”

“…Bone resorption and formation markers change dramatically after fracture of long bones because of the fracture healing and repair process [2,[12][13][14]21]. Bone resorption markers increased soon after a fracture event and bone formation markers increased gradually thereafter.…”