Changes in alkaline phosphatase, calcium, C-reactive protein, D-dimer, phosphorus and hemoglobin in elderly osteoporotic hip fracture patients

Abstract

Background: This study aims to evaluate the association between serum alkaline phosphatase (ALP), calcium (Ca) and phosphorus (P), C-reactive protein (CRP) and D-dimer (D-D), and hemoglobin (Hb) in postoperative and preoperative osteoporotic hip fracture elderly patients.

Methods: A total of 32 operation patients with osteoporotic hip fracture over the age of 65 years old were admitted to the orthopedic unit and prospectively evaluated. All patients were treated according to specific protocols, according to the type of fracture. Fasting blood samples were taken, and serum ALP, Ca and P measurements were respectively performed in six periods: at the time of admission, post-operation, and at postoperative one week, two weeks, one month and three months. Hb, CRP and D-D were also analyzed, and the fracture healing was recorded.

Results: Finally, 32 cases were selected for the present study. The analysis results revealed that the level of serum Ca and ALP slowly increased at two weeks after surgery, and slightly dropped back at three months after the operation. Furthermore, D-D and CRP had a significant effect at pre- and post-operation, and exhibited an obvious downward trend after postoperative one week. The fracture healing and recovery of activities were associated with the Hb levels. The serum levels of ALP, which were adjusted by Ca and P, were associated with Hb and CRP, but not with D-D.

Conclusions: Interestingly, there was an association between CRP and D-D. These findings suggest that early control of inflammation and loss of Ca could play a positive role for the healing of osteoporotic hip fractures.

Keywords: C-reactive protein (CRP); Senile osteoporotic hip fracture; alkaline phosphatase (ALP); calcium (Ca); plasma D-dimer (plasma D-D).