Skip to main content
Erschienen in: Osteoporosis International 1/2011

01.01.2011 | Short Communication

The hormonal profile of hip fracture female patients differs from community-dwelling peers over a 1-year follow-up period

verfasst von: A. R. Cappola, W. G. Hawkes, N. Blocher, J. Yu-Yahiro, D. Orwig, L. Fredman, R. R. Miller, J. M. Guralnik, J. Magaziner

Erschienen in: Osteoporosis International | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

Abstract

Summary

Hormone levels were compared over a 1-year period between elderly women who had sustained a hip fracture and women of similar age and functional ability. Our study suggests progressive hormonal changes that may contribute to severe bone loss during the year following hip fracture.

Introduction

Alterations in hormones affecting the musculoskeletal system may increase risk of hip fracture or poor post-fracture recovery in postmenopausal women. Most studies lack appropriate reference groups, and thus cannot assess the extent to which these alterations are attributable to hip fracture.

Methods

Women aged ≥65 years hospitalized for an acute hip fracture (Baltimore Hip Studies, BHS-3; n = 162) were age-matched to 324 women enrolled in the Women’s Health and Aging Study I, a Baltimore-based cohort with similar functional status to the pre-fracture status of BHS-3 women. Both studies enrolled participants from 1992 to 1995. Insulin-like growth hormone-1 (IGF-1), parathyroid hormone (PTH), 1,25 dihydroxyvitamin D [1,25(OH)2D], and osteocalcin were evaluated at baseline and 2, 6, and 12 months post-fracture, and at baseline and 12 months in the comparison group. Between-group differences in trajectories of each hormone were examined.

Results

Baseline mean IGF-1 levels were significantly lower in hip fracture patients than the comparison group (75.0 vs. 110.5 μg/dL; p < 0.001). Levels increased by 2 months post-fracture, but remained significantly lower than those in the comparison group throughout the 12-month follow-up (p < 0.01). Levels of PTH and osteocalcin were similar between groups at baseline, but rose during the year post-fracture to significantly differ from the comparison women (p < 0.001). 1,25(OH)2D levels did not differ between the hip fracture and comparison women at any time.

Conclusions

Older women who have sustained a hip fracture have progressive changes in hormonal milieu that exceed those of women of similar health status during the year following fracture.
Literatur
1.
Zurück zum Zitat Fox KM, Magaziner J, Hawkes WG, Yu-Yahiro J, Hebel JR, Zimmerman SI, Holder L, Michael R (2000) Loss of bone density and lean body mass after hip fracture. Osteoporos Int 11(1):31–35CrossRefPubMed Fox KM, Magaziner J, Hawkes WG, Yu-Yahiro J, Hebel JR, Zimmerman SI, Holder L, Michael R (2000) Loss of bone density and lean body mass after hip fracture. Osteoporos Int 11(1):31–35CrossRefPubMed
2.
Zurück zum Zitat Magaziner J, Lydick E, Hawkes W, Fox KM, Zimmerman SI, Epstein RS, Hebel JR (1997) Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 87(10):1630–1636CrossRefPubMed Magaziner J, Lydick E, Hawkes W, Fox KM, Zimmerman SI, Epstein RS, Hebel JR (1997) Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 87(10):1630–1636CrossRefPubMed
3.
Zurück zum Zitat Dubin NH, Monahan LK, Yu-Yahiro JA, Michael RH, Zimmerman SI, Hawkes W, Hebel JR, Fox KM, Magaziner J (1999) Serum concentrations of steroids, parathyroid hormone, and calcitonin in postmenopausal women during the year following hip fracture: effect of location of fracture and age. J Gerontol A Biol Sci Med Sci 54(9):M467–M473PubMed Dubin NH, Monahan LK, Yu-Yahiro JA, Michael RH, Zimmerman SI, Hawkes W, Hebel JR, Fox KM, Magaziner J (1999) Serum concentrations of steroids, parathyroid hormone, and calcitonin in postmenopausal women during the year following hip fracture: effect of location of fracture and age. J Gerontol A Biol Sci Med Sci 54(9):M467–M473PubMed
4.
Zurück zum Zitat Yu-Yahiro JA, Michael RH, Dubin NH, Fox KM, Sachs M, Hawkes WG, Hebel JR, Zimmerman SI, Shapiro J, Magaziner J (2001) Serum and urine markers of bone metabolism during the year after hip fracture. J Am Geriatr Soc 49(7):877–883CrossRefPubMed Yu-Yahiro JA, Michael RH, Dubin NH, Fox KM, Sachs M, Hawkes WG, Hebel JR, Zimmerman SI, Shapiro J, Magaziner J (2001) Serum and urine markers of bone metabolism during the year after hip fracture. J Am Geriatr Soc 49(7):877–883CrossRefPubMed
5.
Zurück zum Zitat Giustina A, Mazziotti G, Canalis E (2008) Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 29(5):535–559CrossRefPubMed Giustina A, Mazziotti G, Canalis E (2008) Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 29(5):535–559CrossRefPubMed
6.
Zurück zum Zitat Guralnik JM, Fried LP, Simonsick EM, Kasper JD, Lafferty ME (eds) (1995) The Women's Health and Aging Study: health and social characteristics of older women with disability. National Institute on Aging, Bethesda, NIH Pub. No. 95-4009 Guralnik JM, Fried LP, Simonsick EM, Kasper JD, Lafferty ME (eds) (1995) The Women's Health and Aging Study: health and social characteristics of older women with disability. National Institute on Aging, Bethesda, NIH Pub. No. 95-4009
7.
Zurück zum Zitat Fredman L, Magaziner J, Hawkes W, Hebel JR, Fried LP, Kasper J, Guralnik J (2005) Female hip fracture patients had poorer performance-based functioning than community-dwelling peers over 2-year follow-up period. J Clin Epidemiol 58(12):1289–1298CrossRefPubMed Fredman L, Magaziner J, Hawkes W, Hebel JR, Fried LP, Kasper J, Guralnik J (2005) Female hip fracture patients had poorer performance-based functioning than community-dwelling peers over 2-year follow-up period. J Clin Epidemiol 58(12):1289–1298CrossRefPubMed
8.
Zurück zum Zitat Magaziner J, Wehren L, Hawkes WG, Orwig D, Hebel JR, Fredman L, Stone K, Zimmerman S, Hochberg MC (2006) Women with hip fracture have a greater rate of decline in bone mineral density than expected: another significant consequence of a common geriatric problem. Osteoporos Int 17(7):971–977CrossRefPubMed Magaziner J, Wehren L, Hawkes WG, Orwig D, Hebel JR, Fredman L, Stone K, Zimmerman S, Hochberg MC (2006) Women with hip fracture have a greater rate of decline in bone mineral density than expected: another significant consequence of a common geriatric problem. Osteoporos Int 17(7):971–977CrossRefPubMed
9.
Zurück zum Zitat Boonen S, Mohan S, Dequeker J, Aerssens J, Vanderschueren D, Verbeke G, Broos P, Bouillon R, Baylink DJ (1999) Down-regulation of the serum stimulatory components of the insulin-like growth factor (IGF) system (IGF-I, IGF-II, IGF binding protein [BP]-3, and IGFBP-5) in age-related (type II) femoral neck osteoporosis. J Bone Miner Res 14(12):2150–2158CrossRefPubMed Boonen S, Mohan S, Dequeker J, Aerssens J, Vanderschueren D, Verbeke G, Broos P, Bouillon R, Baylink DJ (1999) Down-regulation of the serum stimulatory components of the insulin-like growth factor (IGF) system (IGF-I, IGF-II, IGF binding protein [BP]-3, and IGFBP-5) in age-related (type II) femoral neck osteoporosis. J Bone Miner Res 14(12):2150–2158CrossRefPubMed
10.
Zurück zum Zitat Hedstrom M, Saaf M, Dalen N (1999) Low IGF-I levels in hip fracture patients. A comparison of 20 coxarthrotic and 23 hip fracture patients. Acta Orthop Scand 70(2):145–148CrossRefPubMed Hedstrom M, Saaf M, Dalen N (1999) Low IGF-I levels in hip fracture patients. A comparison of 20 coxarthrotic and 23 hip fracture patients. Acta Orthop Scand 70(2):145–148CrossRefPubMed
11.
Zurück zum Zitat Akesson K, Vergnaud P, Delmas PD, Obrant KJ (1995) Serum osteocalcin increases during fracture healing in elderly women with hip fracture. Bone 16(4):427–430PubMed Akesson K, Vergnaud P, Delmas PD, Obrant KJ (1995) Serum osteocalcin increases during fracture healing in elderly women with hip fracture. Bone 16(4):427–430PubMed
12.
Zurück zum Zitat Benhamou CL, Tourliere D, Gauvain JB, Picaper G, Audran M, Jallet P (1995) Calciotropic hormones in elderly people with and without hip fracture. Osteoporos Int 5(2):103–107CrossRefPubMed Benhamou CL, Tourliere D, Gauvain JB, Picaper G, Audran M, Jallet P (1995) Calciotropic hormones in elderly people with and without hip fracture. Osteoporos Int 5(2):103–107CrossRefPubMed
13.
Zurück zum Zitat Boonen S, Broos P, Verbeke G, Aerssens J, Van HE, Jans I, Dequeker J, Bouillon R (1997) Calciotropic hormones and markers of bone remodeling in age-related (type II) femoral neck osteoporosis: alterations consistent with secondary hyperparathyroidism-induced bone resorption. J Gerontol A Biol Sci Med Sci 52(5):M286–M293PubMed Boonen S, Broos P, Verbeke G, Aerssens J, Van HE, Jans I, Dequeker J, Bouillon R (1997) Calciotropic hormones and markers of bone remodeling in age-related (type II) femoral neck osteoporosis: alterations consistent with secondary hyperparathyroidism-induced bone resorption. J Gerontol A Biol Sci Med Sci 52(5):M286–M293PubMed
14.
Zurück zum Zitat Rosen C, Donahue LR, Hunter S, Holick M, Kavookjian H, Kirschenbaum A, Mohan S, Baylink DJ (1992) The 24/25-kDa serum insulin-like growth factor-binding protein is increased in elderly women with hip and spine fractures. J Clin Endocrinol Metab 74(1):24–27CrossRefPubMed Rosen C, Donahue LR, Hunter S, Holick M, Kavookjian H, Kirschenbaum A, Mohan S, Baylink DJ (1992) The 24/25-kDa serum insulin-like growth factor-binding protein is increased in elderly women with hip and spine fractures. J Clin Endocrinol Metab 74(1):24–27CrossRefPubMed
15.
Zurück zum Zitat Leboff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J (1999) Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 281(16):1505–1511CrossRefPubMed Leboff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J (1999) Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 281(16):1505–1511CrossRefPubMed
16.
Zurück zum Zitat Cappola AR, Bandeen-Roche K, Wand GS, Volpato S, Fried LP (2001) Association of IGF-I levels with muscle strength and mobility in older women. J Clin Endocrinol Metab 86(9):4139–4146CrossRefPubMed Cappola AR, Bandeen-Roche K, Wand GS, Volpato S, Fried LP (2001) Association of IGF-I levels with muscle strength and mobility in older women. J Clin Endocrinol Metab 86(9):4139–4146CrossRefPubMed
17.
Zurück zum Zitat Maggio M, Ceda GP, De CG, Cattadori E, Visioli S, Ablondi F, Beghi C, Gherli T, Basaria S, Ceresini G, Valenti G, Ferrucci L (2005) Acute changes in circulating hormones in older patients with impaired ventricular function undergoing on-pump coronary artery bypass grafting. J Endocrinol Invest 28(8):711–719PubMed Maggio M, Ceda GP, De CG, Cattadori E, Visioli S, Ablondi F, Beghi C, Gherli T, Basaria S, Ceresini G, Valenti G, Ferrucci L (2005) Acute changes in circulating hormones in older patients with impaired ventricular function undergoing on-pump coronary artery bypass grafting. J Endocrinol Invest 28(8):711–719PubMed
18.
Zurück zum Zitat Semba RD, Garrett E, Johnson BA, Guralnik JM, Fried LP (2000) Vitamin D deficiency among older women with and without disability. Am J Clin Nutr 72(6):1529–1534PubMed Semba RD, Garrett E, Johnson BA, Guralnik JM, Fried LP (2000) Vitamin D deficiency among older women with and without disability. Am J Clin Nutr 72(6):1529–1534PubMed
19.
Zurück zum Zitat Whitson H, DeMarco D, Reilly D, Murphy S, Yett HS, Mattingly D, Greenspan SL (2002) Uncoupling of bone turnover following hip replacement. Calcif Tissue Int 71(1):14–19CrossRefPubMed Whitson H, DeMarco D, Reilly D, Murphy S, Yett HS, Mattingly D, Greenspan SL (2002) Uncoupling of bone turnover following hip replacement. Calcif Tissue Int 71(1):14–19CrossRefPubMed
20.
Zurück zum Zitat Akesson K, Kakonen SM, Josefsson PO, Karlsson MK, Obrant KJ, Pettersson K (2005) Fracture-induced changes in bone turnover: a potential confounder in the use of biochemical markers in osteoporosis. J Bone Miner Metab 23(1):30–35CrossRefPubMed Akesson K, Kakonen SM, Josefsson PO, Karlsson MK, Obrant KJ, Pettersson K (2005) Fracture-induced changes in bone turnover: a potential confounder in the use of biochemical markers in osteoporosis. J Bone Miner Metab 23(1):30–35CrossRefPubMed
21.
Zurück zum Zitat Lamberg-Allardt C, von KJ, Slatis P, Holmstrom T (1989) Vitamin D status and concentrations of serum vitamin D metabolites and osteocalcin in elderly patients with femoral neck fracture: a follow-up study. Eur J Clin Nutr 43(5):355–361PubMed Lamberg-Allardt C, von KJ, Slatis P, Holmstrom T (1989) Vitamin D status and concentrations of serum vitamin D metabolites and osteocalcin in elderly patients with femoral neck fracture: a follow-up study. Eur J Clin Nutr 43(5):355–361PubMed
22.
Zurück zum Zitat Cummings SR, Browner WS, Bauer D, Stone K, Ensrud K, Jamal S, Ettinger B (1998) Endogenous hormones and the risk of hip and vertebral fractures among older women. Study of Osteoporotic Fractures Research Group. N Engl J Med 339(11):733–738CrossRefPubMed Cummings SR, Browner WS, Bauer D, Stone K, Ensrud K, Jamal S, Ettinger B (1998) Endogenous hormones and the risk of hip and vertebral fractures among older women. Study of Osteoporotic Fractures Research Group. N Engl J Med 339(11):733–738CrossRefPubMed
23.
Zurück zum Zitat Garnero P, Sornay-Rendu E, Delmas PD (2000) Low serum IGF-1 and occurrence of osteoporotic fractures in postmenopausal women. Lancet 355(9207):898–899CrossRefPubMed Garnero P, Sornay-Rendu E, Delmas PD (2000) Low serum IGF-1 and occurrence of osteoporotic fractures in postmenopausal women. Lancet 355(9207):898–899CrossRefPubMed
24.
Zurück zum Zitat Garnero P, Munoz F, Sornay-Rendu E, Delmas PD (2007) Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study. Bone 40(3):716–722CrossRefPubMed Garnero P, Munoz F, Sornay-Rendu E, Delmas PD (2007) Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study. Bone 40(3):716–722CrossRefPubMed
25.
Zurück zum Zitat Gerdhem P, Ivaska KK, Alatalo SL, Halleen JM, Hellman J, Isaksson A, Pettersson K, Vaananen HK, Akesson K, Obrant KJ (2004) Biochemical markers of bone metabolism and prediction of fracture in elderly women. J Bone Miner Res 19(3):386–393CrossRefPubMed Gerdhem P, Ivaska KK, Alatalo SL, Halleen JM, Hellman J, Isaksson A, Pettersson K, Vaananen HK, Akesson K, Obrant KJ (2004) Biochemical markers of bone metabolism and prediction of fracture in elderly women. J Bone Miner Res 19(3):386–393CrossRefPubMed
26.
Zurück zum Zitat Ivaska KK, Gerdhem P, Akesson K, Garnero P, Obrant KJ (2007) Effect of fracture on bone turnover markers: a longitudinal study comparing marker levels before and after injury in 113 elderly women. J Bone Miner Res 22(8):1155–1164CrossRefPubMed Ivaska KK, Gerdhem P, Akesson K, Garnero P, Obrant KJ (2007) Effect of fracture on bone turnover markers: a longitudinal study comparing marker levels before and after injury in 113 elderly women. J Bone Miner Res 22(8):1155–1164CrossRefPubMed
27.
Zurück zum Zitat Leboff MS, Hawkes WG, Glowacki J, Yu-Yahiro J, Hurwitz S, Magaziner J (2008) Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 19(9):1283–1290CrossRefPubMed Leboff MS, Hawkes WG, Glowacki J, Yu-Yahiro J, Hurwitz S, Magaziner J (2008) Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 19(9):1283–1290CrossRefPubMed
28.
Zurück zum Zitat Freitag MH, Magaziner J (2006) Post-operative considerations in hip fracture management. Curr Rheumatol Rep 8(1):55–62CrossRefPubMed Freitag MH, Magaziner J (2006) Post-operative considerations in hip fracture management. Curr Rheumatol Rep 8(1):55–62CrossRefPubMed
Metadaten
Titel
The hormonal profile of hip fracture female patients differs from community-dwelling peers over a 1-year follow-up period
verfasst von
A. R. Cappola
W. G. Hawkes
N. Blocher
J. Yu-Yahiro
D. Orwig
L. Fredman
R. R. Miller
J. M. Guralnik
J. Magaziner
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 1/2011
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-010-1187-4

Weitere Artikel der Ausgabe 1/2011

Osteoporosis International 1/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.