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The role of parathyroid hormone (PTH) and vitamin D in falls and hip fracture type

  • Konstantinos Dretakis
  • Vasilios G. IgoumenouEmail author
Original Article
  • 22 Downloads

Abstract

Background

Fragility fractures of the hip are associated with high morbidity and mortality, and represent a rather devastating consequence of osteoporosis. Hip fractures are traditionally investigated as a whole, although it has been recently implied that distinct pathogenic mechanisms may lead either to trochanteric or subcapital fractures.

Aims

To investigate whether differences exist by hip fracture type with respect to serum 25(OH)D (vitamin D) and parathyroid hormone (PTH) levels, in addition to epidemiological and demographic data, including history of falls.

Methods

The inclusion criteria were met by 116 patients [48 men and 68 women; mean age 80.8 ± 8.5 (range 62–94) years]. Patients were analyzed according to hip fracture type, history of falls, and vitamin D and PTH status.

Results

Older age, recurrent falls, serum levels of PTH > 65 pg/ml, and severe vitamin D deficiency were found to be associated with trochanteric fractures. Additionally, older age, female gender, PTH > 65 pg/ml, and severe vitamin D deficiency were related to recurrent falls. Meanwhile, patients with absence of PTH response to low vitamin D levels, were not repeated fallers and suffered mostly from subcapital fractures.

Discussion and conclusion

Elevated PTH levels predispose both to falls and trochanteric fractures, while vitamin D-deficient patients with normal PTH levels are mostly related to subcapital fractures. It is thereby indicated that different pathophysiological processes lie behind subcapital and trochanteric fractures. A better understanding of these mechanisms may assist in the development of prevention strategies for individuals recognized at risk for falls and either type of hip fracture.

Keywords

Parathyroid hormone (PTH) 25 (OH) vitamin D Hip fracture type Falls 

Notes

Acknowledgements

The authors would like to thank Nikolaos Kolaitis, MD, PhD, for his contribution in the statistical analysis of this paper.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. No benefits have been or will be received from a commercial party related directly or indirectly to the subject matter of this article.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Second Department of OrthopaedicsHygeia HospitalAthensGreece
  2. 2.First Department of Orthopaedics, School of MedicineNational and Kapodistrian University of AthensAthensGreece

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