Prevention of secondary hyperparathyroidism and hip fracture in elderly women with calcium and vitamin D3 supplements

1996 ◽  
Vol 6 (S3) ◽  
pp. 60-63 ◽  
Author(s):  
M. C. Chapuy ◽  
P. J. Meunier
Keyword(s):  
Hip Fracture ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D3 ◽  
Elderly Women

scholarly journals Bone mineral density and trabecular bone score in elderly type 2 diabetes Southeast Asian patients with severe osteoporotic hip fractures

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241616
Author(s):  
Linsey U. Gani ◽  
Kundan R. Saripalli ◽  
Karen Fernandes ◽  
Suet F. Leong ◽  
Koh T. Tsai ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Elderly Women ◽  
Trabecular Bone Score ◽  
Southeast Asian ◽  
Mineral Density ◽  
Severe Osteoporosis

Introduction Studies show trabecular bone score (TBS) may provide information regarding bone quality independent of bone mineral density (BMD) in type 2 diabetes (DM2) patients. We analyzed our Southeast Asian severe osteoporotic hip fracture patients to study these differences. Methods We conducted a retrospective cross-sectional analysis of subjects admitted to Changi General Hospital, Singapore with severe osteoporotic hip fractures from 2014–2017 who had BMD performed. Electronic records were reviewed and subjects were classified as having diabetes according to the WHO 2019 criteria. DM2 patients were classified according to their HbA1c into well controlled (HbA1c < 7%) and poorly controlled (HbA1c ≥ 7%) DM2. Results Elderly patients with hip fractures present with average femur neck T scores at the osteoporotic range, however those with DM2 had higher BMD and TBS values compared to non DM2 patients. These differences were statistically significant in elderly women—poorly controlled elderly DM2 women with hip fracture had the highest total hip T-score (-2.57 ± 0.86) vs (-2.76 ± 0.96) in well controlled DM2 and (-3.09 ± 1.01) in non DM2 women with hip fracture, p < 0.001. In contrast, TBS scores were lower in poorly controlled DM2 women with hip fracture compared to well controlled DM2 women with hip fracture (1.22 ± 0.11) vs (1.24 ± 0.09), but these were still significantly higher compared to non DM2 women with hip fracture (1.19 ± 0.10), p < 0.001. In elderly men with hip fractures, univariate analysis showed no statistically significant differences in TBS or hip or LS BMD between those with poorly controlled DM2, well controlled DM2 and non DM2. The differences in TBS and BMD remained significant in all DM2 women with hip fractures even after adjustments for potential confounders. Differences in TBS and BMD in poorly controlled DM2 men with hip fractures only became significant after accounting for potential confounders. However, upon inclusion of LS BMD into the multivariate model these differences were attenuated and remained significant only between elderly women with well controlled DM2 and non DM2 women with hip fractures. Conclusions Elderly patients with DM2 and severe osteoporosis present with hip fractures at a higher BMD and TBS values compared to non DM2 patients. These differences were significant after adjustment for confounders in all DM2 women and poorly controlled DM2 men with hip fractures, TBS differences were attenuated with the inclusion LS BMD. Further studies are needed to ascertain differences in BMD and TBS in older Southeast Asian DM2 patients with variable glycemic control and severe osteoporosis.

scholarly journals Sensitivity of mononuclear leucocytes to glucocorticoids in elderly hip-fracture patients resistant to suppression of plasma cortisol by dexamethasone

1998 ◽  
pp. 659-666 ◽  
Author(s):  
EA van Rijen ◽  
RA Harvey ◽  
RN Barton ◽  
JG Rose ◽  
MA Horan
Keyword(s):  
Hip Fracture ◽  
Concanavalin A ◽  
Plasma Cortisol ◽  
Glucocorticoid Receptors ◽  
Elderly Women ◽  
Peripheral Resistance ◽  
Proximal Femur Fracture ◽  
Peripheral Blood Mononuclear ◽  
Whole Cells ◽  
Mononuclear Leucocytes

OBJECTIVE: Elderly women with proximal femur fracture show a prolonged increase in plasma cortisol, which could have undesirable catabolic effects. Suppression of cortisol by dexamethasone is impaired, suggesting resistance to glucocorticoid effects at feedback inhibitory sites. We therefore wished to find out whether peripheral glucocorticoid sensitivity is normal. DESIGN: Peripheral blood mononuclear leucocytes were used as a model tissue. Blood samples were taken from elderly women about 2 weeks after hip fracture and from elderly control women. Each patient was then given 1 mg dexamethasone at 2300 h followed by further sampling at 0800 and 1600 h the next day. METHODS: Glucocorticoid-receptor binding parameters were measured by incubating whole cells with [3H]dexamethasone for 2 h at 37 degrees C. Inhibition of cell proliferation by dexamethasone was assessed by addition of [3H]thymidine to cells cultured for 65 h with concanavalin A. Cortisol and dexamethasone concentrations were measured in the dexamethasone suppression test. RESULTS: As expected, the hip-fracture patients had raised morning cortisol concentrations and impaired suppression by dexamethasone. The cells of the patients had similar numbers of glucocorticoid receptors to those of the control subjects but higher values for Kd (i.e. a lower binding affinity). The cells of the patients incorporated less [3H]thymidine than the control cells in the absence of dexamethasone. The percentage inhibition by a saturating concentration of dexamethasone was unchanged but the concentration giving half-maximal inhibition was decreased (sensitivity was increased) at the higher of the two concanavalin A concentrations used. CONCLUSIONS: These experiments in mononuclear leucocytes give no evidence of peripheral resistance to glucocorticoids in hip-fracture patients with impaired suppression of cortisol by dexamethasone.

scholarly journals Will Elderly Women Wear Hip Protectors to Prevent Hip Fracture?

1997 ◽  
Vol 26 (suppl 1) ◽  
pp. P30-P30
Author(s):  
M.T.A. Villar ◽  
P.W. Thompson ◽  
P. Hill ◽  
H. Inskip ◽  
C. Cooper
Keyword(s):  
Hip Fracture ◽  
Elderly Women ◽  
Hip Protectors

Bone Mineral Density in Chinese Elderly Women with Hip Fracture

1996 ◽  
Vol 58 (6) ◽  
pp. 385-389
Author(s):  
R.-S. Yang ◽  
T.-K. Liu ◽  
F. J. Dorey ◽  
P.-U. Chieng
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Bone Mineral ◽  
Elderly Women ◽  
Mineral Density ◽  
Chinese Elderly
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