Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 15;19(12):7362.
doi: 10.3390/ijerph19127362.

The Phenotype of Bone Turnover in Patients with Fragility Hip Fracture: Experience in a Fracture Liaison Service Population

Carla Caffarelli  1 , Nicola Mondanelli  2 , Eduardo Crainz  3 , Stefano Giannotti  2 , Bruno Frediani  4 , Stefano Gonnelli  1
Affiliations

The Phenotype of Bone Turnover in Patients with Fragility Hip Fracture: Experience in a Fracture Liaison Service Population

Carla Caffarelli et al. Int J Environ Res Public Health. .

Abstract

Background: Hip fragility fractures are becoming one of the main health care problems in countries with an aging population. This study aimed to evaluate the clinical characteristics and the usefulness of bone turnover markers in patients with a hip fracture. Methods: In a cohort of 363 patients (84.1 ± 9.2 years) with hip fractures we measured 25-hydroxyvitamin D (25OHD), bone alkaline phosphatase, type I collagen β carboxy telopeptide (βCTX), and parathyroid hormone (PTH). We recorded patients’ Charlson Comorbidity Index (CCI) and previous history of fragility fractures. Results: Vitamin D and PTH levels were inversely correlated (r = −024; p < 0.001). The prevalence of 25OHD deficiency was 57.8%, the PTH levels greater than 65 pg/mL was in 47.0 %, and in those who had βCTX values the upper limit was 61.8%. Moreover, 62% of patients with a fragility hip fracture had a history of a previous fracture. The 25OHD serum levels were inversely associated with CCI and a previous fragility fracture. On the contrary, PTH and βCTX serum levels showed a positive significant correlation with CCI and previous fragility fractures. Conclusion: This study confirmed the usefulness of a bone turnover markers assessment, along with the comorbidities and history of previous fragility fractures in order to better identify the risk of hip fracture.

Keywords: Charlson Comorbidity Index; Fracture Liaison Service; PTH; hip fracture; previous fragility fracture; vitamin D; βCTX.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Average Charlson Comorbidity Index (CCI) values by gender in patients with hip fragility fracture.
Figure 2
Figure 2
Parathyroid and 25OH vitamin D serum levels.
Figure 3
Figure 3
Previous fragility fractures in patients with hip fracture (A) and what the most common fracture sites were (B).
Figure 4
Figure 4
The types of hip fractures in the study population.
Figure 5
Figure 5
Percentage of patients with “medial” or “lateral” hip fracture on the basis of the presence of previous fragility fractures.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Compston J.E., McClung M.R., Leslie W.D. Osteoporosis. Lancet. 2019;393:364–376. doi: 10.1016/S0140-6736(18)32112-3. - DOI - PubMed
    1. Cummings S.R., Melton L.J. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359:1761–1767. doi: 10.1016/S0140-6736(02)08657-9. - DOI - PubMed
    1. Bhandari M., Swiontkowski M. Management of acute hip fracture. N. Engl. J. Med. 2017;377:2053–2062. doi: 10.1056/NEJMcp1611090. - DOI - PubMed
    1. Rapp K., Rothenbacher D., Magaziner J., Becker C., Benzinger P., König H.H., Jaensch A., Büchele G. Risk of nursing home admission after femoral fracture compared with stroke, myocardial infarction, and pneumonia. J. Am. Med. Dir. Assoc. 2015;16:715.e7–715.e12. doi: 10.1016/j.jamda.2015.05.013. - DOI - PubMed
    1. Piscitelli P., Neglia C., Feola M., Rizzo E., Argentiero A., Ascolese M., Rivezzi M., Rao C., Miani A., Distante A., et al. Updated incidence and costs of hip fractures in elderly Italian population. Aging Clin. Exp. Res. 2020;32:2587–2593. doi: 10.1007/s40520-020-01497-0. - DOI - PubMed