Effects of protein-rich supplementation and nandrolone in lean elderly women with femoral neck fractures.
OBJECTIVE
To evaluate the effects of a protein-rich liquid supplementation, alone or in combination with the anabolic steroid nandrolone decanoate, on body composition, activities of daily living (ADL) status and the health-related quality of life (HRQoL) after a femoral neck fracture.


METHODS
Sixty women, aged 83 +/- 5 years (mean +/- SD), BMI < 24 kg/m2 (20.4 +/- 2 kg/m2 ) and capable of co-operating, with a femoral neck fracture treated with internal fixation, were randomised to open treatment during 6 months with a protein-rich liquid formula alone (PR, Fortimel, 200 ml/day, 20 g protein/day) or in combination with nandrolone decanoate (PR/N, Deca-Durabol 25 mg i.m./3 weeks) or to a control group (C). The patients were re-examined after 6 and 12 months regarding body weight (BW), lean body mass (LBM, DXA), ADL status according to Katz, HRQoL according to EQ 5-D and fracture healing.


RESULTS
LBM decreased in the C (-1.2 +/- 2 kg) and PR groups (-1.2 +/- 1 kg) but remained the same in the PR/N group (0.3 +/- 1 kg) (P < 0.05 between groups). ADL remained at a high level in the two intervention groups but declined significantly in the C group (P < 0.005 between groups). The decline in HRQoL was least pronounced in the PR/N group at 6 months (P < 0.05 between groups). Patients with fracture healing complications lost more BW (P < 0.05) and LBM (P < 0.01) than patients with uneventful fracture healing.


CONCLUSIONS
Protein-rich liquid supplementation in combination with nandrolone given for 6 months to lean elderly women after a femoral neck fracture may positively affect LBM, ADL and HRQoL.
Karolinska Institutet, Sweden. jan.tidermark@ortoped.sos.sll.se
Jan
J
Tidermark
Sari
S
Ponzer
Pronoti
P
Carlsson
Anita
A
Söderqvist
Kerstin
K
Brismar
Birgitta
B
Tengstrand
Tommy
T
Cederholm
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D045930:Anabolic Agents / Q000494:pharmacology*; D001823:Body Composition / Q000187:drug effects*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000601:surgery; D005526:Food, Formulated; D017102:Fracture Healing / Q000187:drug effects*; D006801:Humans; D009277:Nandrolone / Q000494:pharmacology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D011788:Quality of Life; D016896:Treatment Outcome
D045930:Anabolic Agents; D004044:Dietary Proteins; D009277:Nandrolone