The hormonal profile of hip fracture female patients differs from community-dwelling peers over a 1-year follow-up period.
Hormone levels were compared over a 1-year period between elderly women who had sustained a hip fracture and women of similar age and functional ability. Our study suggests progressive hormonal changes that may contribute to severe bone loss during the year following hip fracture.


BACKGROUND
Alterations in hormones affecting the musculoskeletal system may increase risk of hip fracture or poor post-fracture recovery in postmenopausal women. Most studies lack appropriate reference groups, and thus cannot assess the extent to which these alterations are attributable to hip fracture.


METHODS
Women aged ≥65 years hospitalized for an acute hip fracture (Baltimore Hip Studies, BHS-3; n = 162) were age-matched to 324 women enrolled in the Women's Health and Aging Study I, a Baltimore-based cohort with similar functional status to the pre-fracture status of BHS-3 women. Both studies enrolled participants from 1992 to 1995. Insulin-like growth hormone-1 (IGF-1), parathyroid hormone (PTH), 1,25 dihydroxyvitamin D [1,25(OH)2D], and osteocalcin were evaluated at baseline and 2, 6, and 12 months post-fracture, and at baseline and 12 months in the comparison group. Between-group differences in trajectories of each hormone were examined.


RESULTS
Baseline mean IGF-1 levels were significantly lower in hip fracture patients than the comparison group (75.0 vs. 110.5 μg/dL; p < 0.001). Levels increased by 2 months post-fracture, but remained significantly lower than those in the comparison group throughout the 12-month follow-up (p < 0.01). Levels of PTH and osteocalcin were similar between groups at baseline, but rose during the year post-fracture to significantly differ from the comparison women (p < 0.001). 1,25(OH)2D levels did not differ between the hip fracture and comparison women at any time.


CONCLUSIONS
Older women who have sustained a hip fracture have progressive changes in hormonal milieu that exceed those of women of similar health status during the year following fracture.
Cappola
A R
AR
Division of Endocrinology, Diabetes and Metabolism, University of Pennsylvania School of Medicine, 764 CRB, 415 Curie Blvd., Philadelphia, PA 19104, USA. acappola@mail.med.upenn.edu
Hawkes
W G
WG
Blocher
N
N
Yu-Yahiro
J
J
Orwig
D
D
Fredman
L
L
Miller
R R
RR
Guralnik
J M
JM
Magaziner
J
J
D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000097:blood*; D006728:Hormones / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015675:Osteocalcin / Q000097:blood; D058866:Osteoporotic Fractures / Q000097:blood*; D010281:Parathyroid Hormone / Q000097:blood
D006728:Hormones; D010281:Parathyroid Hormone; D015675:Osteocalcin; D015652:25-Hydroxyvitamin D 2; D007334:Insulin-Like Growth Factor I