Artikel
Fetuin-A serum concentration as predictor of long-term outcome after hip fracture in osteoporotic patients
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Autoren
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Claas Jasper Steffen
- Chirurgische Klinik der Universitätsmedizin Rostock, Unfall-, Hand- und Wiederherstellungschirurgie, Rostock, Germany
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Norina Cornelius
- Chirurgische Klinik der Universitätsmedizin Rostock, Unfall-, Hand- und Wiederherstellungschirurgie, Rostock, Germany
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Philipp Herlyn
- Chirurgische Klinik der Universitätsmedizin Rostock, Unfall-, Hand- und Wiederherstellungschirurgie, Rostock, Germany
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Thomas Mittlmeier
- Chirurgische Klinik der Universitätsmedizin Rostock, Unfall-, Hand- und Wiederherstellungschirurgie, Rostock, Germany
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Dagmar-Christiane Fischer
- Universitäts-Kinder- und Jugendklinik, Rostock., Rostock, Germany
| Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: Osteoporotic hip fractures are associated with high postoperative mortality and subsequently reduced physical function. Fetuin-A is a multifunctional protein that acts as an inhibitor of ectopic calcification while favoring mineralization of bone. Epidemiological studies in elderly women showed an association between Fetuin-A serum levels and BMD. In this retrospective follow-up study we investigated the relation between Fetuin-A serum concentrations and long-term outcome after hip fractures.
Methods: Recently, we analysed bone microarchitecture and kinetics of Fetuin-A at time of fracture (t0) and during postoperative recovery (t1 and t2) in osteoporotic patients presenting with low energy hip fracture [J Clin Densitom 2014]. Roughly 2 years later we re-examined this patient cohort with respect to Fetuin-A serum levels, anthropometric and clinical characteristics, i. e. Harris Hip Score and Merle d'Aubigné and Postel Score, Timed up and go test, Chair rising test, Tandem-stand test and handgrip strength were determined. A trauma centered History of disease including fractures and falls was derived from chart review and interview. A summary score ("overall outcome") was developed and a Principal Components Analysis enabeld us to summarize physical performance as one variable. All data are given as mean ± SDEV. P-values are two-sided and a value below 0.05 was considered significant.
Results and Conclusion: From the patients enrolled previously, 58 (15m/43f; patients (78.8 ± 11.3 years) were still alive and 46 (14m/32f; 80.2 ± 11.7 years) consented to participate. Both of the newly defined variables, i.e. overall outcome and physical performance were positively associated with perioperative serum concentrations of Fetuin-A (t2: r=0.55 and r=0.54 respectively, each p<0.01). Multiple linear regression analysis revealed Fetuin-A serum concentration at t1 and t2 as independent predictors of physical performance.
Perioperative Fetuin-A serum concentrations may serve as predictor of functional outcome in patients with low energy hip fractures.
