Sustained and progressive biochemical disturbances after a hip fracture: an indication for prolonged nutritional support?

Author:

Kermack Alexandra J1,Harvey Nicholas C

Affiliation:

1. MRC Epidemiology Resource Centre, University of Southampton School of Medicine, Southampton General Hospital, Southampton, SO16 6YD, UK

Abstract

Evaluation of: Cappola AR, Hawkes WG, Blocher N et al.: The hormonal profile of hip fracture female patients differs from community-dwelling peers over a 1-year follow-up period. Osteoporos. Int. (2010) (Epub ahead of print). The article being evaluated compares profiles of circulating IGF-1, parathyroid hormone (PTH), 1,25(OH)2-vitamin D and osteocalcin (OC) prospectively over 12 months in hip fracture patients and matched frail elderly controls. PTH, osteocalcin and IGF-1 levels rose steadily in the fracture patients; IGF-1 remained lower than in the controls at all time points, whereas OC and PTH were initially similar in the two groups, becoming greater over 12 months in the fracture group. 1,25(OH)2-vitamin D was similar in both groups and did not change. Vitamin D insufficiency has previously been documented in both cohorts. Although the authors did not control for factors such as calcium intake and bisphosphonate use, these results give useful insights into biochemical changes post-hip fracture. The progressive increase in PTH, OC and IGF-1 suggest that perturbations in bone metabolism may be more persistent than previously thought, requiring longer term support.

Publisher

Future Medicine Ltd

Subject

Geriatrics and Gerontology,General Medicine

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