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Twenty eight male patients with non-pathological fracture neck of femur (FNOF), age range 61-89 years, mean age 74.4 years, presented for surgery for fracture neck of femur to Merlin Park Regional Hospital, Galway Ireland and 28 age and sex matched control patients, age range 60-85 years, mean age 72.4 years who were admitted to the medical ward for various complaints including chest pain, gastroenteritis, and upper respiratory tract infections were included in the study. Following a formal written consent blood were collected for CBC, CMP, and total and free testosterone levels, LH, Estradiol, total 25(OH)D and 1,25(OH)2D, and PTH levels pre-operatively. Bone mineral density was done within 7 days of the incident fracture on the patients and the control groups after enrollment. The study is approved by the local IRB. The results were analyzed using T-test for paired data and Chi-square test for the dichotomous data when applicable. The levels of free and total testosterone (< 0.001), LH (< 0.001), total protein (< 0.001), albumin (< 0.001), PTH (< 0.001), and free estradiol levels (< 0.04) were significantly low in patients with hip fracture compared to controls. The BMD of the femoral neck in g/cm2 were also significantly lower in the patient compared to controls (P < 0.001). Conclusions: Vitamin D and testosterone deficiency are potentially preventable risk factors in elderly male patients with non-pathological hip fracture. Vitamin D deficiency might also be implicated for the rise in PTH levels, secondary hyperparathyroidism and bone mineral disorders. Hormonal treatment may be potential option to prevent osteoporosis and decrease the risk of hip fracture in elderly male patients.

annals of nephrology

The Prevalence of Vitamin D Deficiency and Secondary Hyperparathyroidism in Elderly Male Patients with Hip Fracture: Time for Vitamin D and Testosterone Replacement