Bone Abstracts

Background: Identification of risk factors may help us to understand the pathogenesis of osteoporotic hip fracture as well as to formulate development of better diagnostic, prevention and treatment strategies. The present study was designed to determine the impact of multiple metabolic risk factors such as markers of systemic inflammation (C-reactive protein), body iron stores (ferritin), insulin resistance (HOMA-IR) and bone remodeling (osteoprotegerin), for the prediction of hip fractures in postmenopausal osteoporotic women.

Methods: The study group consisted of 115 postmenopausal women divided into two groups: Group 1 consisted of 49 subjects hospitalized in the Orthopedic Department, Wolfson Medical Center due to the diagnosis of non traumatic hip fracture and Group 2 contained 66 postmenopausal osteoporotic women without history of hip fracture. Metabolic parameters were determined.

Results: Circulating OPG was significantly higher in Group 1 than in Group 2 (205.2±177.1 vs 60.0=±22.3, P<0.0001). While levels of hemoglobin as well as MCV and MCH did not differ between groups, circulating ferritin was significantly higher in Group 1 than in Group 2 (217.9±195.1 vs 49.7±31.3, P<0.0001). In multiple linear regression analysis, which explains about 40% of the variability in CRP, 42% in OPG, and 28% in ferritin, significant by-group differences in terms of these parameters persisted even after adjustment.

Conclusions: Elevated body iron stores reflected by serum ferritin concentrations and bone remodeling marker, osteoprotegerin, are independent predictors of hip fracture in postmenopausal women hospitalized for fragility fracture.

Keywords: osteoprotegerin; ferritin; hip fracture; postmenopausal women; iron