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Quantitative Heel Ultrasonography, 25‐Hydroxyvitamin D, and Urine Amino‐terminal Cross‐linking Telopeptide of Type I Collagen in Patients With a Recent Hip Fracture
Author(s) -
Colt Edward,
Gorich George,
Quinnan Stephen,
Raj Ramona,
Thornton John,
Matti Brenda,
Pierson Richard,
Quinlan Eileen
Publication year - 2009
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2009.28.3.337
Subject(s) - medicine , n terminal telopeptide , hip fracture , urine , heel , vitamin d and neurology , type i collagen , vitamin d deficiency , osteoporosis , gastroenterology , urology , alkaline phosphatase , osteocalcin , biochemistry , chemistry , anatomy , enzyme
Objective. This study examined quantitative heel ultrasonography (QUS), 25‐hydroxyvitamin D (25‐OHD) levels, and urine amino‐terminal cross‐linking telopeptide of type I collagen (NTX‐I) levels in patients with a recent osteoporotic hip fracture to see whether they were clinically useful. Methods. Stiffness index (SI) T scores from QUS, 25‐OHD levels, and urine NTX‐I levels were obtained in 53 female and 32 male patients with hip fractures. Sixty‐five female patients and 5 male patients attending our geriatric clinic were used for comparison. Results. The SI T scores of the hip fracture patients were less than those of the geriatric clinic patients. The difference was significant in female patients ( P = .0001) but not in male patients ( P = .1). Serum levels of 25‐OHD were less than 28 ng/mL in 50 of 59 patients and less than 5 ng/mL in 2 patients. Levels of urine NTX‐I were variable and were not correlated with other parameters. Conclusions. Patients who have had a hip fracture have a low SI determined by QUS; this is easy to perform, and it provides a baseline T score from which to assess treatment effects. Most of these patients are vitamin D deficient, and measurement of the 25‐OHD level would enable physicians to prescribe an appropriate dose of vitamin D. Urine NTX‐I measured shortly after a hip fracture is not clinically helpful.