Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 54, Issue 9 M467-M473, Copyright © 1999 by The Gerontological Society of America
Serum concentrations of steroids, parathyroid hormone, and calcitonin in postmenopausal women during the year following hip fracture: effect of location of fracture and age
NH Dubin, LK Monahan, JA Yu-Yahiro, RH Michael, SI Zimmerman, W Hawkes, JR Hebel, KM Fox and J Magaziner
Department of Gynecology and Obstetrics, Union Memorial Hospital, Baltimore, USA. [email protected]
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
+/- 4.6 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 PTH during the year after fracture.
