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Fibroblast Growth Factor-23, Sclerostin, and Bone Microarchitecture in Patients With Osteoporotic Fractures of the Proximal Femur: A Cross-sectional Study.
Herlyn, Philipp K E; Cornelius, Norina; Haffner, Dieter; Zaage, Franziska; Kasch, Cornelius; Schober, Hans-Christof; Mittlmeier, Thomas; Fischer, Dagmar-C.
Affiliation
  • Herlyn PK; Department of Traumatology, Hand and Reconstructive Surgery, University of Rostock, Rostock, Germany.
  • Cornelius N; Department of Traumatology, Hand and Reconstructive Surgery, University of Rostock, Rostock, Germany.
  • Haffner D; Department of Paediatrics, University of Rostock, Rostock, Germany.
  • Zaage F; Department of Paediatrics, University of Rostock, Rostock, Germany.
  • Kasch C; Department of Orthopaedics, University of Rostock, Rostock, Germany.
  • Schober HC; Department of Internal Medicine, Klinikum Südstadt Rostock, Rostock, Germany.
  • Mittlmeier T; Department of Traumatology, Hand and Reconstructive Surgery, University of Rostock, Rostock, Germany.
  • Fischer DC; Department of Paediatrics, University of Rostock, Rostock, Germany. Electronic address: dagmar-christiane.fischer@med.uni-rostock.de.
J Clin Densitom ; 19(2): 192-201, 2016.
Article in En | MEDLINE | ID: mdl-25439456
This cross-sectional observational cohort study was designed to simultaneously investigate bone microarchitecture and serum markers of bone metabolism in elderly osteoporotic patients experiencing a trochanteric or femoral neck fracture. Special emphasis was put on renal function, sclerostin and fibroblast growth factor-23 (FGF-23). Eighty-two patients (median age: 84 years; 49 trochanteric fractures) scheduled for emergency surgery due to an osteoporotic fracture participated. Bone specimens for ex vivo microcomputed X-ray tomography were sampled during surgery. Blood samples for laboratory workup were collected before surgery (t0) and 1 day afterward (t1). Fifty-eight patients consented to dual-energy X-ray absorptiometry scanning of the lumbar spine and/or contralateral femoral neck after recovery during the in-patient stay. Samples were grouped according to the site of fracture. Regression coefficients were controlled for age and/or estimated glomerular filtration rate (eGFR), if appropriate. Patients experiencing a femoral neck fracture presented with better preserved renal function (eGFR) and lower C-terminal fragment of fibroblast growth factor-23 (cFGF-23) concentrations compared to those with trochanteric fractures. By contrast, serum sclerostin was similar at both time points and did not differ between groups. Age-adjusted correlation analysis revealed negative associations between eGFR and cFGF-23 determined at t1 (R=-0.34; p<0.05) as well as between eGFR and sclerostin levels at t0 (R=-0.45; p<0.05) in patients with trochanteric and femoral neck fractures, respectively. Our study provides evidence that not only an age-related decline of renal function but also the type of skeletal injury may contribute to the circulating concentrations of cFGF-23.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Bone Density / Femoral Neck Fractures / Osteoporotic Fractures / Fibroblast Growth Factors Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male Country/Region as subject: Europa Language: En Journal: J Clin Densitom Journal subject: ORTOPEDIA Year: 2016 Document type: Article Affiliation country: Germany Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Bone Density / Femoral Neck Fractures / Osteoporotic Fractures / Fibroblast Growth Factors Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male Country/Region as subject: Europa Language: En Journal: J Clin Densitom Journal subject: ORTOPEDIA Year: 2016 Document type: Article Affiliation country: Germany Country of publication: United States