title: The possible role of locally produced cytokines in the pathogenesis of peritrochanteric fractures in the elderly.
abstract: Sixteen patients with intertrochanteric femoral fractures were studied for possible involvement of the cytokines interleukin-6 (IL-6), interleukin-1 beta (IL-1beta), tumor necrosis factor-alpha, and the disease activity factors C-reactive protein and alpha1-antitrypsin as local bone-resorbing agents. Cytokine and disease activity factor levels were measured in gluteus medius muscle and serum samples and were compared to sera obtained from age- and sex-matched healthy controls. Interleukin-6 and IL-1beta levels were significantly higher (P=.0024 and P=.036, respectively) in the muscle samples from the fractured side than in the samples from the contralateral unaffected side. Levels of IL-6 and IL-1beta also were significantly higher in patients' sera than in the sera of healthy controls. These results support a new hypothesis that may contribute to the pathogenesis of fractures in the elderly: unilaterally locally over-produced IL-6 and IL-1beta may lead to local bone resorption in the intertrochanteric region, which subsequently weakens the femoral bone and increases the risk of unilateral peritrochanteric fractures.
authors.affiliation: Department of Microbiology, School of Medicine, University of Patras, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Spiliopoulou
authors.forename: P
authors.initials: P
authors.lastname: Korovessis
authors.forename: M
authors.initials: M
authors.lastname: Stamatakis
authors.forename: F
authors.initials: F
authors.lastname: Paliogianni
authors.forename: G
authors.initials: G
authors.lastname: Dimitracopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D007375:Interleukin-1 / Q000502:physiology*; D015850:Interleukin-6 / Q000502:physiology*; D008297:Male; D008875:Middle Aged
chemical_list: D007375:Interleukin-1; D015850:Interleukin-6