Indices of calcium metabolism in women with hip fractures

Cooper, Cyrus; McLaren, Mairi; Wood, Peter; Coulton, Les; Kanis, JA

doi:10.1016/0169-6009(89)90096-2

Cited by 45 publications

(27 citation statements)

References 19 publications

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“…The finding of a decreased osteocalcin level in a hipfracture population has been described [7,18,30], but no difference [31] or an increase has also been found [16]. These variations may be explained by the time elapsed between fracture and the collection of the samples, which has not been clearly stated and apparently has ranged from within 24 to 48 hours to weeks in some cases.…”

Section: Discussionmentioning

confidence: 92%

“…There is an age-related increase of serum osteocalcin and other markers of bone turnover in normal women, with a sharp increase at the time of menopause [12][13][14][15]. In elderly osteoporotic subjects sustaining hip fracture, both increased [16] and decreased [17,18] osteocalcin levels have been noted, but measurements were performed in a limited number of patients and in most cases several days to weeks after fracture.The assessment of bone resorption has recently been improved by the measurement of urinary excretion of pyridinoline and deoxypyridinoline cross-links. The collagen chains are connected by intramolecular cross-links, based on aldehyde forms of the amino acids lysine and hydroxylysine, to give tensile strength to collagen tissue.…”

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confidence: 94%

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Impairment of bone turnover in elderly women with hip fracture

et al. 1993

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Hip fracture is one of the most severe consequences of osteoporosis affecting aged women. However, abnormalities of bone turnover responsible for bone loss in this condition have not been clearly defined. To further evaluate the bone metabolic status of women sustaining hip fracture, we have prospectively measured serum osteocalcin as a marker of bone formation and urinary excretion of pyridinoline (Pyr) and deoxypyridinoline (D-pyr) cross-links as markers of bone collagen degradation in 174 independently living women (80 +/- 8 years) within a few hours after a hip fracture. Comparison was made with 77 age-matched controls (80 +/- 5 years) and 17 premenopausal women (39 +/- 3 years). In addition 15 of the patients were followed with daily measurements during the first postoperative week. At the time of admission osteocalcin was 20% lower in the fractured women compared to the elderly controls (7.6 +/- 3.8 vs. 9.5 +/- 4.5 ng/ml, P = 0.001). Pyr and D-pyr were 36% and 40% higher, respectively (P = 0.0001), than in elderly controls and 85% and 76% higher than in premenopausal controls (P = 0.0001). Serum osteocalcin did not correlate with the cortisol level measured at the same time (r = 0.03, ns), nor with serum albumin and creatinine. Serum osteocalcin remained unchanged within 18 hours after fracture, whereafter it progressively decreased until the third postoperative day. No correlation was noted between the excretion of pyridinoline cross-links and the time elapsed from fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 92%

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confidence: 94%

Impairment of bone turnover in elderly women with hip fracture

et al. 1993

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“…This points to a better nutritional status and a better general condition among the participants in the community control group, and emphasized the frailer condition of hospitalized patients, especially those who sustain a hip fracture. The trauma itself does not decrease 25(OH)D levels [16]. A high proportion of Table 1.…”

Section: Discussionmentioning

confidence: 98%

“…While osteomalacia appears to be uncommon in the majority of patients with hip fracture, subclinical vitamin D deficiency may often promote hip fracture by leading to secondary hyperparathyroidism which in turn would increase bone turnover and accelerate bone loss [10][11][12][13]. Various studies have reported conflicting results concerning parathyroid hormone (PTH) levels in patients with hip fracture compared with control groups [14][15][16][17]. Vitamin D deficiency is the consequence of poor nutrition and lack of sun exposure in elderly people confined to an indoor life.…”

Section: Introductionmentioning

confidence: 99%

Importance of Albumin, 25(OH)-Vitamin D and IGFBP-3 as Risk Factors in Elderly Women and Men with Hip Fracture

Thiébaud¹,

Burckhardt²,

Costanza

et al. 1997

Osteoporosis International

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The relative importance of vitamin D deficiency, secondary hyperparathyroidism, nutritional deficiency and low bone mineral density (BMD) as risk factors for hip fracture is not definitely established. In the framework of a case-control study of risk factors for hip fractures, biochemical markers of bone metabolism and nutrition and femoral BMD data were compared in 136 female and 43 male hip fracture patients, 136 female and 44 male age-matched hospitalized controls, and 47 healthy elderly women (8 men). Patients with hip fracture had lower albumin (-10%) and 25(OH)-vitamin D (25(OH)D; -19%) compared with hospitalized controls, and lower albumin (-28%) and 25(OH)D levels (-52%) compared with the elderly controls. Serum values of IGFBP-3 were also significantly lower (-33%) in hip fracture patients than in community controls. BMD of femoral neck was lower (p < 0.001) in patients than in hospitalized and community controls. In hip fracture patients, parathyroid hormone (PTH) correlated weakly with BMD (neck: r = -0.19, trochanter: r = -0.17; both p < 0.05). When all women were pooled (n = 233), albumin correlated significantly (age-adjusted) with BMD at all sites (neck: r = 0.27, trochanter: r = 0.25; all p < 0.001). Albumin, but not 25(OH)D, also correlated with skinfold thickness (r = 0.19, p < 0.0025) and with body mass index (BMI) (r = 0.14, p < 0.05). Male patients with hip fracture had lower BMD and albumin (both p < 0.001), 25(OH)D (p = 0.02) and IGFBP-3 levels (p < 0.005) compared with the controls. When male patients and controls were pooled together, albumin, skinfold thickness and BMI were significantly correlated with each other, but not with BMD. IGFBP-3 was highly correlated with albumin (p < 0.0001), 25(OH)D (p < 0.005) and, less significantly, with PTH (p < 0.05), but not with BMI or skinfold thickness. IGFBP-3 was significantly correlated with BMD at all sites (neck: r = 0.27, p < 0.05; trochanter: r = 0.40, p < 0.0005). In conclusion, low albumin and low BMD were both important risk factors for hip fracture. Low serum albumin was the strongest independent variable correlated with hip fractures. In men. IGFBP-3 was correlated with BMD. The femoral BMD depended only weakly on PTH and 25(OH)D, but was correlated at all sites with albumin, a non-specific parameter of nutrition and general health.

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“…Lower serum osteocalcin levels in women sustaining hip fractures have been indicated when the sampiing was done within 24 hours after fracture [9,28]. After a week and up to several months, an increase of serum osteocalcin has been noted for both hip fractures and diaphyseal fractures [9,10,29].…”

Section: Discussionmentioning

confidence: 99%

Serum osteocalcin and fracture susceptibility in elderly women

et al. 1993

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The purpose of this investigation was to evaluate the bone turnover by using bone metabolic markers in relation to previous fracture history and independent of bone mass. Patients and controls were recruited from a population-based study of 193 women, all living in the same city and aged 60, 70, and 80 years. The bone mineral content (BMC) was measured bilaterally in the distal forearm by single-photon absorptiometry (SPA). At the same time, serum samples were obtained for biochemical analysis. Of the 193 women, we identified 26 with at least one major fracture during the past few years. Each of these 26 women with a certified recent previous fracture was individually matched with a woman from the same study group of equal BMC and age but without a fracture history. In the two groups, the serum samples were analyzed for osteocalcin, C-terminal procollagen peptide (P1CP), alkaline phosphatase, bone-specific alkaline phosphatase, calcium, phosphate, and albumin. The serum concentration of osteocalcin was 20% lower in the women with a previous fracture than in the controls (P = 0.03). The other markers of bone formation gave similar values in the two groups. There was a significant correlation between the osteocalcin and P1CP concentrations (P = 0.001). Our findings indicate that the susceptibility to fractures independent of factors such as age and BMC may be related to a decreased bone turnover.

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Indices of calcium metabolism in women with hip fractures

Cited by 45 publications

References 19 publications

Impairment of bone turnover in elderly women with hip fracture

Impairment of bone turnover in elderly women with hip fracture

Importance of Albumin, 25(OH)-Vitamin D and IGFBP-3 as Risk Factors in Elderly Women and Men with Hip Fracture

Serum osteocalcin and fracture susceptibility in elderly women

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