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With respect to the pathogenesis of osteoporosis, primary and secondary forms of the disease can be distinguished. It has been recognized that the incidence of primary and secondary osteoporosis differs in women and men.
The aim of the present study was to assess the incidence and gender distribution of factors contributing to osteoporosis in older hip fracture patients.
In this cross-sectional study 404 patients with hip fractures and controls referred to an acute geriatric care department over a period of 15 months were included. The medical history was recorded and blood samples were analyzed for routine laboratory parameters.
A total of 249 patients with hip fractures and 155 matched controls were studied. The Tinetti test and the Barthel index were found to show highly significant differences in both groups mainly because of the postoperative state of patients with fractures. Vitamin D deficiency was found in 94.1 % of male fracture patients and 94.6 % of female fracture patients. On average 2.4 secondary contributors of osteoporosis were present in male fracture patients versus 2.9 in male controls and 2.3 in female fracture patients versus 2.3 in female controls. For most parameters no significant gender differences of possible secondary contributors to osteoporosis were found. Secondary osteoporosis was diagnosed in all male fracture patients and in 56.2 % of all female fracture patients.
Based on the findings of this study it is recommended that hip fracture patients should be assessed for secondary contributors of osteoporosis. Although the overall distribution of secondary contributors was similar in women and men, the prevalence of secondary osteoporosis was higher in men.
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Baztan JJ, Suarez-Garcia FM, Lopez-Arrieta J, Rodriguez-Manas L, Rodriguez-Artalejo F (2009) Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis. BMJ 338:b50
Bogoch ER, Elliot-Gibson V, Wang RY, Josse RG (2012) Secondary causes of osteoporosis in fracture patients. J Orthop Trauma 26:e145–e152
De Laet C, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ III, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338 CrossRefPubMed
Ellis G, Whitehead MA, Robinson D, OʼNeill D, Langhorne P (2011) Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. BMJ 343:d6553
Ensrud KE, Blackwell TL, Cauley JA, Cummings SR, Barrett-Connor E, Dam TT, Hoffman AR, Shikany JM, Lane NE, Stefanick ML, Orwoll ES, Cawthon PM (2011) Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study. J Am Geriatr Soc 59:101–106 PubMedCentralCrossRefPubMed
Guigoz Y, Vellas B, Garry PJ (1996) Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 54:S59–S65
Gumieiro DN, Rafacho BP, Goncalves AF, Tanni SE, Azevedo PS, Sakane DT, Carneiro CA, Gaspardo D, Zornoff LA, Pereira GJ, Paiva SA, Minicucci MF (2012) Mini Nutritional Assessment predicts gait status and mortality 6 months after hip fracture. Br J Nutr 109:1657–1661
Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65 PubMed
Nelson RG, Tuttle KR, Bilous RW, Gonzalez-Campoy JM, Mauer M, Molitch ME, Sharma K, Fradkin JE, Narva AS, Wilt TJ, Ishani A, Rector TS, Slinin Y, Fitzgerald P, Carlyle M, Rocco MV, Berns JS, Nally JV Jr, Kramer H, Choi MJ, Willis K, Howell E, Cheung M, Slifer S. (2012) KDOQI clinical practice guideline for diabetes and CKD: 2012 update. Am J Kidney Dis 60:850–886 CrossRef
Seitz S, Koehne T, Ries C, De Novo Oliveira A, Barvencik F, Busse B, Eulenburg C, Schinke T, Puschel K, Rueger JM, Amling M, Pogoda P (2012) Impaired bone mineralization accompanied by low vitamin D and secondary hyperparathyroidism in patients with femoral neck fracture. Osteoporos Int 24:641–649
von Renteln-Kruse W, Ebert D (2003) [Characteristics of hospitalized geriatric patients–a comparison of two cohorts using the screening of the Arbeitsgemeinschaft Geriatrisches Basisassessment (AGAST)]. Z Gerontol Geriatr 36:223–232
Klahr S, Levey AS, Beck GJ et al (1994) The effects of dietary protein restiction and blood-pressure control on the progression of chronic reanl disease. Modification of Diet in Renal Disease Study Group. N Engl J Med 330:877–884
- Secondary confounders of osteoporotic hip fractures in patients admitted to a geriatric acute care department
MD Dr. Peter Dovjak
Mag. Ursula Föger-Samwald
MD Maarit Konrad
MD Bernhard Bichler
Univ. Prof. Peter Pietschmann
- Springer Berlin Heidelberg