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Risk factors for hip fracture in Japanese elderly women with osteoporosis: Applicability of biochemical markers in bone turnover

Authors

  • Toshiki Shiga,

    1. Department of Orthopedic Surgery, Nantan General Hospital,
    2. Department of Orthopedic Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, and
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  • Yoshiro Tsuji,

    1. Department of Orthopedic Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, and
    2. Department of Orthopedic Surgery, Kyoto Prefectural Rehabilitation Hospital for the Disabled, Kyoto, Japan
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  • Mikihiro Fujioka,

    1. Department of Orthopedic Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, and
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  • Toshikazu Kubo

    1. Department of Orthopedic Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, and
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Dr Toshiki Shiga MD, Department of Orthopedic Surgery, Nantan General Hospital 25 Ueno, Yagi, Yagi-cho, Nantan 629-0193, Kyoto, Japan; and Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Kyoto, Japan. Email: s-shiga@dc4.so-net.ne.jp

Abstract

Aim:  The purpose of this study was to investigate risk factors for hip fracture in 169 Japanese elderly women.

Methods:  Patients were divided into three groups: 53 patients had osteoporosis with hip fractures (FX-G), 59 patients had osteoporosis without hip fractures (NFX-G) and 57 patients had low back pain with neither osteoporosis nor hip fracture (NOP-G). Bone mineral density (BMD) of lumbar spine, bone-specific alkaline phosphatase (BAP) and deoxypyridinoline (DPD) were compared among the three groups.

Results:  The mean BMD of FX-G and NFX-G was lower than that of NOP-G, but there was no significant difference between FX-G and NFX-G. Although the mean BAP of FX-G was similar to that of NOP-G, both were lower than NFX-G (P < 0.05). However, the mean DPD of FX-G was higher than the other groups (P < 0.05, vs NFX-G, P < 0.001, vs NOP-G). The percentage of patients who showed BAP levels less than 35 IU/L and DPD levels of 7.5 nmoL/mmol-Cr or more, was highest in FX-G (72.7%). This percentage was lower for NFX-G (30.9%) and NOP-G (16.4%). The odds ratio of hip fracture occurring was 5.77 (95% confidence interval, 2.25−14.66).

Conclusion:  Bone turnover consisting of increase in bone resorption and decrease in bone formation apart from BMD of lumbar spine resulted in a higher incidence of hip fracture for Japanese elderly women with osteoporosis.

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