Hip Fracture Essay

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Serum N-terminal propeptide of type 1 collagen (P1NP) in Elderly Patients with Hip Fracture: Relationship with Sociodemographic and Clinical Characteristics, Other Parameters of Bone and Mineral Metabolism, and Short-term Outcomes

Advanced Trainee in Geriatric Medicine, the Canberra Hospital

Introduction: The relationships between serum N-terminal propeptide of type 1 collagen [P1NP], a marker of bone formation, with metabolic and clinical factors have rarely been determined and remain unclear.
Aims: To evaluate in patients with a hip fracture the association between serum P1NP concentration (on admission) and clinical characteristics as well as short-term outcomes.
Materials and Methods:
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A further multivariate regression analysis revealed that the lowest tertile of serum P1NP concentration (≤29.3µg/L) was found to be significantly associated with nursing home residence (P-value 0.034) after adjustment for age, gender and presence of hypertension; and also to be inversely associated with ALP (P-value 0.000), OC (P-value 0.000) and β-CTX (P-value 0.001) after adjustment for age, gender, ALP, OC, and β-CTX.
Conclusions: In elderly patients with a hip fracture, serum P1NP concentration had an inverse relationship with age, GGT, and markers of inflammation such as CRP and NLR; and a positive relationship with the bone turnover markers OC and β-CTX, ALP, and may predict prolonged length of hospital stay and new nursing home discharge.

What is Known in Regards to Serum N-terminal propeptide of type 1 collagen (P1NP)
• Predominantly produced by osteoblasts and minor amounts synthesised by the liver
• Recommended as a marker of bone formation by international institutions.
• Serum P1NP concentrations decrease after administration of bisphosphonates and selective oestrogen receptor modulators, and increase with teriparatide therapy.
• Higher P1NP concentrations are associated with myocardial infarction in elderly male patients, and
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