Inflammatory cytokines IL-6 and TNF-α in patients with hip fracture

  • D. Saribal
  • F. S. Hocaoglu-EmreEmail author
  • S. Erdogan
  • N. Bahtiyar
  • S. Caglar Okur
  • M. Mert
Original Article



Mortality and remaining bedridden following the hip fracture surgery are not rare. We tried to measure the levels of inflammatory markers tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) following the hip fracture surgery and compare their levels with controls. We aimed to show a relationship between the levels of these markers and post-operative mortality and walking capability.


Osteoporosis is a condition, causing the hip fractures in the elderly. Hip fractures have a high rate of overall mortality up to 30% following the incident. Cytokines such as IL-6 and TNF-α are suggested to play a role in bone resorption and, thus, in the etiology of osteoporosis.


Plasma levels of IL-6 and TNF-α were measured pre-operatively and on the first and second days after the surgery in 40 Turkish hip fracture patients. The levels of these cytokines were compared with 40 Turkish age-matched healthy controls. The levels of these cytokines were compared between the deceased and surviving patients, as well as the existence of walking capability following the surgery.


Significantly higher IL-6 levels were shown on the first and second days after the surgery (p = 0.005; p = 0.01, respectively). The overall death rate of our study group within the 2-year follow-up time was found to be 35%. No statistical significance was found in the means of 2-year follow-up mortality between the patients. Presence of walking capability did not differ between the patients, as well.


We demonstrated an association between IL-6 levels and hip fracture in our study group following the surgery. We also suggest that TNF-α and IL-6 levels are not related to the occurrence of death and walking capability after the surgery. However, these findings need further functional and clinical confirmation.


Hip fracture TNF-α IL-6 Cytokines Tumor necrosis factor-alpha Interleukin-6 


Compliance with ethical standards

Written informed consent was obtained from all the participants. The study was approved by the local ethics committee and carried out in compliance with the Helsinki declaration.

Conflict of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • D. Saribal
    • 1
  • F. S. Hocaoglu-Emre
    • 2
    Email author
  • S. Erdogan
    • 3
  • N. Bahtiyar
    • 1
  • S. Caglar Okur
    • 4
  • M. Mert
    • 5
  1. 1.Department of BiophysicsIstanbul University Cerrahpaşa Medical FacultyIstanbulTurkey
  2. 2.Department of Nutrition and DieteticsBeykent UniversityIstanbulTurkey
  3. 3.Department of Orthopedic SurgeryIstanbul Metin Sabanci Baltalimanı Training and Research Hospital for Bone DiseasesIstanbulTurkey
  4. 4.Department of Physical Treatment and RehabilitationBakirkoy Sadi Konuk Training and Research HospitalIstanbulTurkey
  5. 5.Department of Orthopedic SurgeryYeniyuzyil University Medical SchoolIstanbulTurkey

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