J Vaculik1,2,3, L Wenchich4, M Bobelyak1,2, K Pavelka4,5, J J Stepan6,7. 1. Orthopedic Department, Bulovka Hospital, Prague, Czech Republic. 2. Third Faculty of Medicine, Charles University, Prague, Czech Republic. 3. Orthopedic Department, First Faculty of Medicine, Charles University, Prague, Czech Republic. 4. Institute of Rheumatology, Prague, Czech Republic. 5. Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic. 6. Institute of Rheumatology, Prague, Czech Republic. stepan@revma.cz. 7. Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic. stepan@revma.cz.
Abstract
OBJECTIVE: Although calcitriol is essential for bone healing, its serum concentrations are low after hip surgery, and they continue to decline during bone healing. This study aimed to test the hypothesis of an association of changes in calcitriol production with the status of fibroblast growth factor 23 (FGF23) and iron deficiency after elective hip replacement for coxarthrosis. METHODS: In this prospective study, we measured the biomarkers of 17 patients undergoing elective hip replacement on admission, on the first day after surgery, and at the regular check-up after 48 ± 8 days. The serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, transferrin, ferritin, parathyroid hormone, intact plasma FGF23 (iFGF23) and C-terminal FGF23 (cFGF23) were determined. RESULTS: In our patients who underwent elective hip replacement, significant correlations existed between the percent change in the conversion rate of 25(OH)D to 1,25(OH)2D, plasma intact to C-terminal FGF23 ratio, and serum iron. CONCLUSIONS: The production of calcitriol is compromised after elective hip replacement surgery, leading to reduced levels of active vitamin D in the serum. Significant correlations between the percent change in the conversion rate of 25(OH)D to 1,25(OH)2D, plasma intact to C-terminal FGF23 ratio, and serum iron on the first day as well as 7 weeks after surgery could inspire future studies to determine whether and how calcitriol deficiency should be corrected, especially in fracture cases.
OBJECTIVE: Although calcitriol is essential for bone healing, its serum concentrations are low after hip surgery, and they continue to decline during bone healing. This study aimed to test the hypothesis of an association of changes in calcitriol production with the status of fibroblast growth factor 23 (FGF23) and iron deficiency after elective hip replacement for coxarthrosis. METHODS: In this prospective study, we measured the biomarkers of 17 patients undergoing elective hip replacement on admission, on the first day after surgery, and at the regular check-up after 48 ± 8 days. The serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, transferrin, ferritin, parathyroid hormone, intact plasma FGF23 (iFGF23) and C-terminal FGF23 (cFGF23) were determined. RESULTS: In our patients who underwent elective hip replacement, significant correlations existed between the percent change in the conversion rate of 25(OH)D to 1,25(OH)2D, plasma intact to C-terminal FGF23 ratio, and serum iron. CONCLUSIONS: The production of calcitriol is compromised after elective hip replacement surgery, leading to reduced levels of active vitamin D in the serum. Significant correlations between the percent change in the conversion rate of 25(OH)D to 1,25(OH)2D, plasma intact to C-terminal FGF23 ratio, and serum iron on the first day as well as 7 weeks after surgery could inspire future studies to determine whether and how calcitriol deficiency should be corrected, especially in fracture cases.
Authors: Robert Zura; Ze Xiong; Thomas Einhorn; J Tracy Watson; Robert F Ostrum; Michael J Prayson; Gregory J Della Rocca; Samir Mehta; Todd McKinley; Zhe Wang; R Grant Steen Journal: JAMA Surg Date: 2016-11-16 Impact factor: 14.766
Authors: J A Yu-Yahiro; R H Michael; N H Dubin; K M Fox; M Sachs; W G Hawkes; J R Hebel; S I Zimmerman; J Shapiro; J Magaziner Journal: J Am Geriatr Soc Date: 2001-07 Impact factor: 5.562
Authors: Adam D M Briggs; Valerie Kuan; Claire L Greiller; Beverley D Maclaughlin; Manoj Ramachandran; Timothy Harris; Peter M Timms; Timothy R Venton; Reinhold Vieth; Anthony W Norman; Christopher J Griffiths; Adrian R Martineau Journal: J Bone Miner Res Date: 2013-06 Impact factor: 6.741