Purpose
Osteoporotic fracture has been increased nowadays. The significance of bone quality including bone turnover rate has become important. Biochemical markers of bone turnover are useful in diagnosis and monitoring response to treatment. However, high within-person variability complicates their use. We investigated whether the bone mineral density and bone turnover marker (serum C-terminal telopeptide; CTx and osteocalcin) were associated the patients with femur fracture and/or vertebral fracture, and also whether the sampling time influence the level of CTx.
Methods
From January 2005 to December 2005, we had enrolled prospectively 12 patients with vertebral fracture and 30 of those with femur fracture who visited the emergency department. Bone mineral densities of the lumbar spine and femur were examined. Total calcium, phosphate, alkaline phosphatase and osteocalcin were measured. Serum CTx was measured at the time of visiting emergency room, which was identified as random sampling, and the next morning. Clinical characteristics of patients with femur fracture were further investigated with two subgroups - with or without vertebral fracture.
Results
Bone mineral densities of all patients showed osteoporosis. The mean of s-CTx levels in the femur fracture group was higher than control. The CTx levels of the morning samples were higher than random samplings, showing correlation (r=0.63, p<0.01). Patients with femur fracture accompanying vertebral fracture were older than femur fracture only group, and had lower BMD. There were no significant differences in the bone turnover markers between all the subgroups. But the proportion of trochanteric fracture was higher in femur fracture with vertebral fracture than femur fracture only group.
Conclusion
Fragility fracture in the elderly was associated with osteoporosis, especially in femur fracture with vertebral fracture. The bone turnover markers and bone mineral densities are useful to assess the degree of ost
