Serum concentrations of steroids, parathyroid hormone, and calcitonin in postmenopausal women during the year following hip fracture: Effect of location of fracture and age
Serum concentrations of steroids, parathyroid hormone, and calcitonin in postmenopausal women during the year following hip fracture: Effect of location of fracture and age
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DOI：
10.1093/gerona/54.9.m467
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发表时间：
1999-09-01
影响因子：
5.1
通讯作者：
Magaziner, J
中科院分区：
文献类型：
--
作者：
Dubin, NH;Monahan, LK;Magaziner, J
背景髋部骨折在老年人中是一个主要的健康问题，特别是考虑到老年人在人口中的比例不断增加。本研究检测了绝经后妇女髋部骨折后循环中激素水平的变化，这些激素据称会影响骨代谢。患者包括65岁及以上的女性，在骨折后2天内接受了手术。在骨折后3、10、60、180和360天采集血清样本。来自相同年龄范围的无髋部骨折的健康女性作为对照组（n = 17）。激素测定采用放射免疫法。将股骨颈区骨折的受试者（n = 78）与转子区骨折的受试者（n = 88）进行比较。骨折后3天雌酮浓度（47.6 +/- 5.7 pg/mL;平均值+/- SEM）升高（p <0.001），而对照组水平为20.7 +/- 3.6 pg/mL。到2个月时，水平已降至对照水平。雄烯二酮和肾上腺激素，DHEAS和皮质醇，表现出类似的反应。骨折后3天，甲状旁腺激素（PTH）水平与对照组无显著差异，但在骨折后一年内升高（p <0.001）。骨折后3天降钙素浓度（42.1 +/- 3.7 pg/mL）比无骨折对照组（9.8 +/- 3 pg/mL）高得多（p <0.001）。除睾酮外，骨折部位无差异。只有PTH，浓度较高，在老年组（p <0.001），表现出年龄相关的response.Conclusions，髋关节骨折后，有一些戏剧性的反应激素，据称是机械重要的骨代谢。这些变化包括骨折后一年内类固醇激素的短暂增加、降钙素的慢性升高和MN水平的升高。
Background. Hip fracture in the aged is a major health problem, especially considering the increasing proportion of the elderly in the population. This study examines changes in circulating levels of hormones, which are purported to affect bone metabolism, in response to hip fracture in postmenopausal women.Methods. Patients consisted of women ages 65 and older who had surgery within 2 days of fracture. Serum samples were obtained at 3, 10, 60, 180, and 360 days postfracture. Healthy women without hip fractures from the same age range served as a control group (n = 17). Hormones were determined by radioimmunoassay. Subjects with fractures in the neck region of the femur (n = 78) were compared to subjects with fractures in the trochanteric region (n = 88).Results. Estrone concentration (47.6 +/- 5.7 pg/mL; mean +/- SEM) at 3 days postfracture was elevated (p < .001) compared to control levels of 20.7 +/- 3.6 pg/mL. By 2 months, levels had declined to control levels. Androstenedione and the adrenal hormones, DHEAS and cortisol, displayed similar responses. Parathyroid hormone (PTH) levels were not significantly different from the control concentration at 3 days following fracture, but increased (p < .001) during the year following fracture. Calcitonin concentrations were much higher (p < .001) 3 days postfracture (42.1 +/- 3.7 pg/mL) compared to controls without fracture (9.8 +/- 3 pg/mL). Except for testosterone, no differences could be attributed to fracture location. Only PTH, with concentrations higher in the older age groups (p < .001), showed an age-related response.Conclusions, Following hip fracture, there are some dramatic responses in hormones that purportedly are mechanistically important in bone metabolism. These changes include transient increases in steroid hormones, chronic elevations in calcitonin, and rising levels of MN during the year after fracture.