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The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type.
Aging Clin Exp Res. 2019 Oct; 31(10):1501-1507.AC

Abstract

BACKGROUND

Fragility fractures of the hip are associated with high morbidity and mortality, and represent a rather devastating consequence of osteoporosis. Hip fractures are traditionally investigated as a whole, although it has been recently implied that distinct pathogenic mechanisms may lead either to trochanteric or subcapital fractures.

AIMS

To investigate whether differences exist by hip fracture type with respect to serum 25(OH)D (vitamin D) and parathyroid hormone (PTH) levels, in addition to epidemiological and demographic data, including history of falls.

METHODS

The inclusion criteria were met by 116 patients [48 men and 68 women; mean age 80.8 ± 8.5 (range 62-94) years]. Patients were analyzed according to hip fracture type, history of falls, and vitamin D and PTH status.

RESULTS

Older age, recurrent falls, serum levels of PTH > 65 pg/ml, and severe vitamin D deficiency were found to be associated with trochanteric fractures. Additionally, older age, female gender, PTH > 65 pg/ml, and severe vitamin D deficiency were related to recurrent falls. Meanwhile, patients with absence of PTH response to low vitamin D levels, were not repeated fallers and suffered mostly from subcapital fractures.

DISCUSSION AND CONCLUSION

Elevated PTH levels predispose both to falls and trochanteric fractures, while vitamin D-deficient patients with normal PTH levels are mostly related to subcapital fractures. It is thereby indicated that different pathophysiological processes lie behind subcapital and trochanteric fractures. A better understanding of these mechanisms may assist in the development of prevention strategies for individuals recognized at risk for falls and either type of hip fracture.

Authors+Show Affiliations

Second Department of Orthopaedics, Hygeia Hospital, Athens, Greece.First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. vasigou@med.uoa.gr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30701437

Citation

Dretakis, Konstantinos, and Vasilios G. Igoumenou. "The Role of Parathyroid Hormone (PTH) and Vitamin D in Falls and Hip Fracture Type." Aging Clinical and Experimental Research, vol. 31, no. 10, 2019, pp. 1501-1507.
Dretakis K, Igoumenou VG. The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type. Aging Clin Exp Res. 2019;31(10):1501-1507.
Dretakis, K., & Igoumenou, V. G. (2019). The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type. Aging Clinical and Experimental Research, 31(10), 1501-1507. https://doi.org/10.1007/s40520-019-01132-7
Dretakis K, Igoumenou VG. The Role of Parathyroid Hormone (PTH) and Vitamin D in Falls and Hip Fracture Type. Aging Clin Exp Res. 2019;31(10):1501-1507. PubMed PMID: 30701437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type. AU - Dretakis,Konstantinos, AU - Igoumenou,Vasilios G, Y1 - 2019/01/30/ PY - 2018/12/21/received PY - 2019/01/16/accepted PY - 2019/2/1/pubmed PY - 2019/11/19/medline PY - 2019/2/1/entrez KW - 25 (OH) vitamin D KW - Falls KW - Hip fracture type KW - Parathyroid hormone (PTH) SP - 1501 EP - 1507 JF - Aging clinical and experimental research JO - Aging Clin Exp Res VL - 31 IS - 10 N2 - BACKGROUND: Fragility fractures of the hip are associated with high morbidity and mortality, and represent a rather devastating consequence of osteoporosis. Hip fractures are traditionally investigated as a whole, although it has been recently implied that distinct pathogenic mechanisms may lead either to trochanteric or subcapital fractures. AIMS: To investigate whether differences exist by hip fracture type with respect to serum 25(OH)D (vitamin D) and parathyroid hormone (PTH) levels, in addition to epidemiological and demographic data, including history of falls. METHODS: The inclusion criteria were met by 116 patients [48 men and 68 women; mean age 80.8 ± 8.5 (range 62-94) years]. Patients were analyzed according to hip fracture type, history of falls, and vitamin D and PTH status. RESULTS: Older age, recurrent falls, serum levels of PTH > 65 pg/ml, and severe vitamin D deficiency were found to be associated with trochanteric fractures. Additionally, older age, female gender, PTH > 65 pg/ml, and severe vitamin D deficiency were related to recurrent falls. Meanwhile, patients with absence of PTH response to low vitamin D levels, were not repeated fallers and suffered mostly from subcapital fractures. DISCUSSION AND CONCLUSION: Elevated PTH levels predispose both to falls and trochanteric fractures, while vitamin D-deficient patients with normal PTH levels are mostly related to subcapital fractures. It is thereby indicated that different pathophysiological processes lie behind subcapital and trochanteric fractures. A better understanding of these mechanisms may assist in the development of prevention strategies for individuals recognized at risk for falls and either type of hip fracture. SN - 1720-8319 UR - https://www.unboundmedicine.com/medline/citation/30701437/The_role_of_parathyroid_hormone__PTH__and_vitamin_D_in_falls_and_hip_fracture_type_ L2 - https://dx.doi.org/10.1007/s40520-019-01132-7 DB - PRIME DP - Unbound Medicine ER -