A study on serum parameters and bone density In patients above 50 years with fractures

Introduction Once unknown, later taken for granted as an inexorable sequel to the process of aging, osteoporosis in now regarded as a disabling or morbid condition of importance as to deserve more study, mainly because of the increase in the number of the older persons and the economic implications. It is also known that there is a change in serum parameters like serum calcium, serum phosphorus, serum alkaline phosphatase and serum acid phosphatase after trauma. It was hence decided to study bone density with serum parameters which are commonly done as a preoperative work up of elderly patients with fracture. In our study Bone densitometry was measured indirectly by the digital X-Ray radiogrammetry (Pronosco-X-Posure system). MATERIAL AND METHOD We conducted this study in the Department of Orthopaedics and Traumatology, NSCB Medical College, Jabalpur on 36 elderly patient above 50 years with fractures of their long bones, spine or pelvis, who got admitted between Nov. 2005 and July 2006. History of bone disease, diseases impacting on bone metabolism and those using drugs that affect bone including, bisphophonates, oestrogen, calcitonin, steroids, tamoxifen, and raloxifene were excluded. Other exclusion factors included prolonged hospitalization or immobilization and limited use of one or both arms within 6 months of the study. We divided our elderly patients with fracture into three groups : 1- Normal, 2-Osteopenic and 3- Osteoporotic group according to T-score value based on WHO criteria. We took the mean of serum parameters among these groups and compared their value in these elderly patients with fractures and tried to find out any correlation with T-score and Z-score. We also studied the cases according to the fracture pattern and age group with 10 year intervals. For correlation we used Pearson's correlation coefficient. Each participant was given both written and oral information about the study. The study is conducted in accordance with the revised Helisnki Declaration, the International Conference on Harmonisation's (ICH's) guidelines for good clinical practice, and local regulations. For serum parameters we used automatic blood cell counter for Hb, total leukocyte count (TLC) and differential leukocyte count (DLC) and ESR. We used randox auto analyzer for blood sugar, blood urea, serum protein, serum creatinine, serum protein, serum calcium, serum alkaline phosphatase, serum phosphorus, serum acid phosphatase and lipid profile including cholesterol, LDL, HDL and triglycerides.