Các yếu tố phụ gây mất xương trong gãy xương hông liên quan đến loãng xương

Springer Science and Business Media LLC - Tập 19 - Trang 991-999 - 2008
B. J. Edwards1,2, C. B. Langman3, A. D. Bunta2, M. Vicuna1, M. Favus4
1Bone Health and Osteoporosis Center, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
2Bone Health and Osteoporosis Center, Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, USA
3Bone Health and Osteoporosis Center, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, USA
4Department of Medicine, University of Chicago, Chicago, USA

Tóm tắt

Việc điều trị loãng xương cho bệnh nhân bị gãy xương hông là cần thiết để ngăn ngừa các gãy xương tiếp theo. Các nguyên nhân thứ phát dẫn đến mất xương có mặt ở hơn 80% bệnh nhân bị gãy xương hông, vì vậy cần thực hiện đánh giá tình trạng Vitamin D, các rối loạn hấp thụ và bài tiết canxi, gammopathies đơn dòng và chức năng thận. Xác định và quản lý các rối loạn này sẽ cải thiện khả năng phát hiện và nâng cao việc điều trị nhằm giảm nguy cơ gãy xương tái phát ở người cao tuổi. Mục đích của nghiên cứu này là xác định tỷ lệ mắc các rối loạn ảnh hưởng đến quá trình chuyển hóa xương và khoáng chất ở những cá nhân bị gãy xương hông do loãng xương. Những cá nhân cư trú tại cộng đồng có gãy xương hông (HFx) trên 50 tuổi. Đánh giá tình trạng vitamin D, tình trạng thận và tuyến cận giáp, khả năng hấp thụ canxi và các rối loạn tế bào plasma. Trong số 157 HFx, tuổi trung bình là 70 ± 10 năm, HFx có mức creatinine cao hơn (p = 0.002, 95% C.I. -0.09, 0.05); mức 25 OH vitamin D thấp hơn (p = 0.019, 95% C.I. 6.5, 2.7), albumin (p = 0.007, 95% C.I. 0.36, 0.009), và canxi nước tiểu 24 giờ (p = 0.024, 95% CI 51, 21) so với nhóm đối chứng. Hơn 80% HFx có ít nhất một tình trạng chưa được chẩn đoán trước đó, với thiếu Vitamin D (61%), bệnh thận mạn tính (16%) (CKD), gammopathy đơn dòng (6%) và hấp thụ canxi kém (5%) là những trường hợp phổ biến nhất. Một trường hợp đa u tủy và một trường hợp u tủy đơn độc đã được xác định. Việc điều trị loãng xương cho HFx là cần thiết để ngăn ngừa các gãy xương tiếp theo. Các nguyên nhân thứ phát gây mất xương rất phổ biến ở HFx; do đó, cần thực hiện đánh giá tình trạng vitamin D, các rối loạn hấp thụ và bài tiết canxi, điện di protein và chức năng thận. Xác định và điều chỉnh những rối loạn này sẽ cải thiện phát hiện và nâng cao điều trị nhằm giảm nguy cơ gãy xương tái phát ở người cao tuổi.

Từ khóa

#loãng xương #gãy xương hông #Vitamin D #mất xương #chức năng thận #hấp thụ canxi #gammopathy đơn dòng

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