%0 Journal Article
%T Cardiovascular diseases in older patients with osteoporotic hip fracture: prevalence, disturbances in mineral and bone metabolism, and bidirectional links
%A Fisher A
%A Srikusalanukul W
%A Davis M
%A Smith P
%J Clinical Interventions in Aging
%D 2013
%I 
%R http://dx.doi.org/10.2147/CIA.S38856
%X rdiovascular diseases in older patients with osteoporotic hip fracture: prevalence, disturbances in mineral and bone metabolism, and bidirectional links Original Research (745) Total Article Views Authors: Fisher A, Srikusalanukul W, Davis M, Smith P Published Date February 2013 Volume 2013:8 Pages 239 - 256 DOI: http://dx.doi.org/10.2147/CIA.S38856 Received: 05 October 2012 Accepted: 04 December 2012 Published: 25 February 2013 A Fisher,1,3 W Srikusalanukul,1 M Davis,1,3 P Smith2,3 1Departments of Geriatric Medicine, 2Orthopaedic Surgery, The Canberra Hospital, 3Australian National University Medical School, Canberra, ACT, Australia Background: Considerable controversy exists regarding the contribution of mineral/bone metabolism abnormalities to the association between cardiovascular diseases (CVDs) and osteoporotic fractures. Aims and methods: To determine the relationships between mineral/bone metabolism biomarkers and CVD in 746 older patients with hip fracture, clinical data were recorded and serum concentrations of parathyroid hormone (PTH), 25-hydroxyvitamin D, calcium, phosphate, magnesium, troponin I, parameters of bone turnover, and renal, liver, and thyroid functions were measured. Results: CVDs were diagnosed in 472 (63.3%) patients. Vitamin D deficiency was similarly prevalent in patients with (78.0%) and without (82.1%) CVD. The CVD group had significantly higher mean PTH concentrations (7.6 vs 6.0 pmol/L, P < 0.001), a higher prevalence of secondary hyperparathyroidism (SPTH) (PTH > 6.8 pmol/L, 43.0% vs 23.3%, P < 0.001), and excess bone resorption (urinary deoxypyridinoline corrected by creatinine [DPD/Cr] > 7.5 nmol/¦̀mol, 87.9% vs 74.8%, P < 0.001). In multivariate regression analysis, SHPT (odds ratio [OR] 2.6, P = 0.007) and high DPD/Cr (OR 2.8, P = 0.016) were independent indictors of CVD. Compared to those with both PTH and DPD/Cr in the normal range, multivariate-adjusted ORs for the presence of CVD were 17.3 (P = 0.004) in subjects with SHPT and 9.7 (P < 0.001) in patients with high DPD/Cr. CVD was an independent predicator of SHPT (OR 2.8, P = 0.007) and excess DPD/Cr (OR 2.5, P = 0.031). CVD was predictive of postoperative myocardial injury, while SHPT was also an independent predictor of prolonged hospital stay and in-hospital death. Conclusion: SHPT and excess bone resorption are independent pathophysiological mediators underlying the bidirectional associations between CVD and hip fracture, and therefore are important diagnostic and therapeutic targets.
%K cardiovascular disease
%K hip fracture
%K PTH
%K 25(OH)D
%K secondary hyperparathyroidism
%K bone turnover
%K mineral metabolism
%U https://www.dovepress.com/cardiovascular-diseases-in-older-patients-with-osteoporotic-hip-fractu-peer-reviewed-article-CIA