B J Edwards1, C B Langman, A D Bunta, M Vicuna, M Favus. 1. Bone Health and Osteoporosis Center, Department of Medicine, Feinberg School of Medicine, Northwestern University, 645 N Michigan, suite 630, Chicago, IL 60611, USA. bje168@northwestern.edu
Abstract
UNLABELLED: Osteoporosis treatment of patients with hip fractures is necessary to prevent subsequent fractures. Secondary causes for bone loss are present in more than 80% of patients with hip fractures, and therefore, assessment of Vitamin D status, disorders in calcium absorption and excretion, monoclonal gammopathies, and renal function should be performed. Identifying and managing these disorders will improve detection and enhance treatment aimed at reducing the risk of recurrent fractures in older adults. INTRODUCTION: The purpose of this study was to determine the prevalence of disorders affecting bone and mineral metabolism in individuals with osteoporotic hip fractures. METHODS: Community dwelling individuals with hip fractures (HFx) 50 years of age and older. Assessment for vitamin D, renal and parathyroid status, calcium absorption, and plasma cell disorders. RESULTS: Of 157 HFx, mean age 70 +/- 10 years, HFx had higher creatinine (p = 0.002, 95% C.I. -0.09, 0.05); lower 25 OH vitamin D (p = 0.019, 95% C.I. 6.5, 2.7), albumin (p = 0.007, 95% C.I. 0.36, 0.009), and 24-h urine calcium (p = 0.024, 95% CI 51, 21) as compared to controls. More than 80% of HFx had at least one previously undiagnosed condition, with vitamin D insufficiency (61%), chronic kidney disease (16%) (CKD), monoclonal gammopathy (6%), and low calcium absorption (5%) being the most common. One case each of multiple myeloma and solitary plasmocytoma were identified. CONCLUSIONS: Osteoporosis treatment of HFx is necessary to prevent subsequent fractures. Secondary causes for bone loss are remarkably common in HFx; therefore, assessment of vitamin D status, disorders in calcium absorption and excretion, protein electrophoresis, and renal function should be performed. Identifying and correcting these disorders will improve detection and enhance treatment aimed at reducing the risk of recurrent fractures in older adults.
UNLABELLED: Osteoporosis treatment of patients with hip fractures is necessary to prevent subsequent fractures. Secondary causes for bone loss are present in more than 80% of patients with hip fractures, and therefore, assessment of Vitamin D status, disorders in calcium absorption and excretion, monoclonal gammopathies, and renal function should be performed. Identifying and managing these disorders will improve detection and enhance treatment aimed at reducing the risk of recurrent fractures in older adults. INTRODUCTION: The purpose of this study was to determine the prevalence of disorders affecting bone and mineral metabolism in individuals with osteoporotic hip fractures. METHODS: Community dwelling individuals with hip fractures (HFx) 50 years of age and older. Assessment for vitamin D, renal and parathyroid status, calcium absorption, and plasma cell disorders. RESULTS: Of 157 HFx, mean age 70 +/- 10 years, HFx had higher creatinine (p = 0.002, 95% C.I. -0.09, 0.05); lower 25 OH vitamin D (p = 0.019, 95% C.I. 6.5, 2.7), albumin (p = 0.007, 95% C.I. 0.36, 0.009), and 24-h urine calcium (p = 0.024, 95% CI 51, 21) as compared to controls. More than 80% of HFx had at least one previously undiagnosed condition, with vitamin Dinsufficiency (61%), chronic kidney disease (16%) (CKD), monoclonal gammopathy (6%), and low calcium absorption (5%) being the most common. One case each of multiple myeloma and solitary plasmocytoma were identified. CONCLUSIONS:Osteoporosis treatment of HFx is necessary to prevent subsequent fractures. Secondary causes for bone loss are remarkably common in HFx; therefore, assessment of vitamin D status, disorders in calcium absorption and excretion, protein electrophoresis, and renal function should be performed. Identifying and correcting these disorders will improve detection and enhance treatment aimed at reducing the risk of recurrent fractures in older adults.
Authors: John Cunningham; Stuart M Sprague; Jorge Cannata-Andia; Maria Coco; Martine Cohen-Solal; Lorraine Fitzpatrick; David Goltzmann; Marie-Helene Lafage-Proust; Mary Leonard; Susan Ott; Mariano Rodriguez; Catherine Stehman-Breen; Paula Stern; Jose Weisinger Journal: Am J Kidney Dis Date: 2004-03 Impact factor: 8.860
Authors: Sophie A Jamal; Douglas C Bauer; Kristine E Ensrud; Jane A Cauley; Marc Hochberg; Areef Ishani; Steven R Cummings Journal: J Bone Miner Res Date: 2007-04 Impact factor: 6.741
Authors: Nguyen D Nguyen; Chatlert Pongchaiyakul; Jacqueline R Center; John A Eisman; Tuan V Nguyen Journal: J Bone Miner Res Date: 2005-05-31 Impact factor: 6.741
Authors: Steven M Petak; Howard R Nankin; Richard F Spark; Ronald S Swerdloff; Luis J Rodriguez-Rigau Journal: Endocr Pract Date: 2002 Nov-Dec Impact factor: 3.443
Authors: Ann V Schwartz; Teresa A Hillier; Deborah E Sellmeyer; Helaine E Resnick; Edward Gregg; Kristine E Ensrud; Pamela J Schreiner; Karen L Margolis; Jane A Cauley; Michael C Nevitt; Dennis M Black; Steven R Cummings Journal: Diabetes Care Date: 2002-10 Impact factor: 19.112
Authors: Cathleen Colón-Emeric; Maragatha Kuchibhatla; Carl Pieper; William Hawkes; Lisa Fredman; Jay Magaziner; Sheryl Zimmerman; Kenneth W Lyles Journal: Osteoporos Int Date: 2003-10-03 Impact factor: 4.507
Authors: Beatrice J Edwards; Dennis W Raisch; Veena Shankaran; June M McKoy; William Gradishar; Andrew D Bunta; Athena T Samaras; Simone N Boyle; Charles L Bennett; Dennis P West; Theresa A Guise Journal: Clin Cancer Res Date: 2011-02-01 Impact factor: 12.531
Authors: Julie Glowacki; Mitchel B Harris; Josef Simon; John Wright; Nikheel S Kolatkar; Thomas S Thornhill; Meryl S Leboff Journal: Int J Endocrinol Date: 2010 Impact factor: 3.257