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Body composition and hip fracture type in elderly women

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Abstract

Many observations support the view that there are significant differences between patients sustaining trochanteric fractures and those sustaining cervical fractures of the hip. Our aim was to evaluate the association between soft tissue composition (fat and lean compartments) and the type of hip fracture sustained. Of 120 consecutive women affected by their first hip fracture admitted to our rehabilitation hospital 102 were included in this cross-sectional study. Body composition was assessed by DXA. Body fat mass was lower in the women with trochanteric fracture than in those with cervical fracture (difference between groups: 2.86 kg; 95% CI 0.10–5.61 kg; p=0.042). The percentage of fat was 30.75±8.77 (mean±SD) versus 34.75±7.29 (difference between groups: 4.00; 95% CI 0.84–7.16; p=0.014). In contrast, no meaningful differences in body lean mass were shown between the two groups. Logistic multiple regression showed that fat mass was associated with the type of fracture independently of age, height, weight, time between fracture occurrence and DEXA assessment, comorbidity, number of drugs in use, lean mass and bone mineral content. The logistic regression results were similar when fat percentage was substituted for fat mass. The data show that fat but not lean body mass is associated with the type of hip fracture, contributing to the definition of the differences between patients sustaining cervical or trochanteric fractures. We stress the importance of distinguishing the two types of fracture when clinical or epidemiological studies related to body composition, including those regarding nutrition or physical exercise, are performed.

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Abbreviations

BMD:

Bone mineral density

DEXA:

Dual-energy X-ray absorptiometry

BMC:

Bone mineral content

References

  1. Vega E, Mautalen C, Gomez H, Garrido A, Melo L, Sahores A (1991) Bone mineral density in patients with cervical and trochanteric fractures of the proximal femur. Osteoporosis Int 1:81–86

    CAS  Google Scholar 

  2. Greenspan S, Myers E, Maitland L, Kido T, Krasnow M, Hayes W (1994) Trochanteric bone mineral density is associated with type of hip fracture in the elderly. J Bone Miner Res 9:1889–1894

    CAS  PubMed  Google Scholar 

  3. Stewart A, Porter RW, Primrose WR, Walker LG, Reid DM (1999) Cervical and trochanteric hip fractures: bone mass and other parameters. Clin Rheumatol 18:201–206

    Article  CAS  PubMed  Google Scholar 

  4. Gallagher J, Melton L, Riggs B, Bergstrath E (1980) Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Rel Res 150:163–171

    Google Scholar 

  5. Uitewaal P, Lips P, Netelenbos J (1987) An analysis of bone structure in patients with hip fracture. Bone Min 3:63–73

    CAS  Google Scholar 

  6. Mautalen C, Vega E, Einhorn T (1996) Are the etiologies of cervical and trochanteric hip fractures different? Bone 18:133–137

    Article  PubMed  Google Scholar 

  7. Gluer C, Cummings S, Pressman A et al. (1994) Prediction of hip fractures from pelvic radiographs: The study of osteoporotic fractures. J Bone Miner Res 9:671–677

    PubMed  Google Scholar 

  8. Dretakis K, Dretakis E, Papakitsou E, Psarakis S, Steriopoulos K (1998) Possible predisposing factors for the second hip fracture. Calcif Tissue Int 62:366–369

    Article  CAS  PubMed  Google Scholar 

  9. Ensrud KE, Lipschutz RC, Cauley JA et al. (1997) Body size and hip fracture risk in older women: a prospective study. Study of the Osteoporotic Research Group. Am J Med 103:274–280

    Article  CAS  PubMed  Google Scholar 

  10. Heymsfield SB, Wang Z, Baumgartner RN, Ross R (1997) Human body composition: advances in models and methods. Annu Rev Nutr 17:527–558

    Article  CAS  PubMed  Google Scholar 

  11. Nguyen TV, Howard GM, Kelly PJ, Eisman JA (1998) Bone mass, lean mass, and fat mass: same genes or same environments? Am J Epidemiol 147:3–16

    CAS  PubMed  Google Scholar 

  12. Ralston SH (2002) Genetic control of susceptibility to osteoporosis. J Clin Endocrinol Metab 87:2460–2466

    Google Scholar 

  13. Roux S (2001) The genetics of osteoporosis. Joint Bone Spine 68:482–486

    Article  CAS  PubMed  Google Scholar 

  14. Grant SF, Reid DM, Blake G, Herd R, Fogelman I, Ralston SH (1996) Reduced bone density and osteoporosis associated with a polymorphic Sp1 binding site in the collagen type I alpha 1 gene. Nature Genet 14:203–205

    CAS  PubMed  Google Scholar 

  15. Efsathiadou Z, Kranas V, Ioannidis JP, Georgiou I, Tsatsoulis A (2001) The Sp1 COLIAL gene polymorphism, and not vitamin D receptor or estrogen receptor gene polymorphisms, determines bone mineral density in postmenopausal Greek women. Osteoporos Int 12:326–331

    Article  CAS  PubMed  Google Scholar 

  16. Marquita-Raya P, Munoz-Torres M, de Dios Luna J et al. (2002) Performance of COLIA1 polymorphism and bone turnover markers to identify postmenopausal women with prevalent vertebral fractures. Osteoporosis Int ;13:506–512

    Google Scholar 

  17. Qureshi AM, McGuigan FE, Seymour DG, Hutchison JD, Reid DM, Ralston SH (2001) Association between COLIAL Sp1 alleles and femoral neck geometry. Calcif Tissue Int 69:67–72

    CAS  PubMed  Google Scholar 

  18. Reseland JE, Syversen U, Bakke I et al. (2001) Leptin is expressed in and secreted from primary cultures of human osteoblasts and promotes bone mineralization. J Bone Miner Res 16:1426–143 3

    CAS  PubMed  Google Scholar 

  19. Holloway WR, Collier FM, Aitken CJ et al. (2002) Leptin inhibits osteoclast generation. J Bone Miner Res 17:200–209

    CAS  PubMed  Google Scholar 

  20. Meier CA, Bobbioni E, Gabay C, Assimacopoulos-Jeannet F, Goaly A, Dayer JM (2002) IL-1 receptor antagonist serum levels are increased in human obesity: a possible link to the resistance to leptin? J Clin Endocrinol Metab 87:1184–1188

    CAS  PubMed  Google Scholar 

  21. Ducy P, Amling M, Takeda S et al. (2000) Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 100:197–207

    CAS  PubMed  Google Scholar 

  22. Cornish J, Callon KE, Reid IR (1996) Insulin increases histomorphometric indices of bone formation in vivo. Calcif Tissue Int 59:492–495

    Article  CAS  PubMed  Google Scholar 

  23. Conover CA (2000) In vitro studies of insulin-like growth factor I and bone. Growth Horm IGF Res 10:107–110

    Article  CAS  PubMed  Google Scholar 

  24. Fox KM, Magaziner J, Hawkes W et al. (2000) Loss of bone density and lean body mass after hip fracture. Osteoporosis Int 11:31–35

    CAS  Google Scholar 

  25. Magnusson H, Linden C, Obrant K, Johnell O, Karlsson M (2001) Bone mass changes in weight-loaded and unloaded skeletal regions following a fracture of the hip. Calcif Tissue Int 69:78–83

    CAS  PubMed  Google Scholar 

  26. Fox KM, Cummings S, Williams E, Stone K (2000) Femoral neck and intertrochanteric fractures have different risk factors: a prospective study. Osteoporos Int 11:1018–1023

    Article  CAS  PubMed  Google Scholar 

  27. Di Monaco M, Di Monaco R, Mautino F, Cavanna A (2002) Femur bone mineral density, age and fracture type in 300 hip-fractured women. Aging Clin Exp Res 14:47–51

    Google Scholar 

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Di Monaco, M., Vallero, F., Di Monaco, R. et al. Body composition and hip fracture type in elderly women. Clin Rheumatol 23, 6–10 (2004). https://doi.org/10.1007/s10067-003-0750-1

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