The Role of Adipokines As Prognostic Factors of One-year Mortality in Hip Fracture Patients

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2017 May 15

PMID 28501890

Citations 4

Authors

T Gulin

I Kruljac

L S Kirigin Bilos

M Gulin

M Grgurevic

M Borojevic

Affiliations

Soon will be listed here.

Abstract

Introduction: Several predictors of one-year hip fracture mortality have been identified including advanced age, male sex, low bone mineral density, and preexisting comorbidities. However, the impact of metabolic parameters on hip fracture mortality remains unknown. The aim of this study was to examine the effect of serum leptin and adiponectin levels, as well as other metabolic parameters on all-cause one-year hip fracture mortality.

Methods: This prospective study included 236 patients of all ages with non-traumatic hip fractures. Anthropometric parameters, adiponectin, leptin, HOMA-IR, β-CTX, and routine biochemical tests were recorded at admission and correlated with one-year mortality by using multivariate Cox proportional hazard models.

Results: The median patient age was 82 (75-87) years, and one-year mortality rate was 28.4%. In univariate analysis, adiponectin, age, β-CTX, and renal function were associated with mortality. However, in a multivariate model, male gender, high β-CTX, adiponectin, and leptin were independently associated with increased mortality. Thus, we constructed a nomogram that included all the latter variables in addition to age. The nomogram predicted mortality with a sensitivity of 74.8% (66.0-82.3) and specificity of 74.4% (57.9-87.0), and had an area under the curve of 0.784. Patients that scored <9.2 had a mortality of 10.1%, while those with >9.2 had a mortality of 49.2% (relative risk 5.4, 95% CI 2.8-10.2, P < 0.001).

Conclusion: Male patients with high adiponectin, leptin, and β-CTX levels have a 5-fold increase in all-cause one-year mortality after hip fracture.

Citing Articles

Effect of adipokine and ghrelin levels on BMD and fracture risk: an updated systematic review and meta-analysis.

Lee S, Kim J, Jeon Y, Lee J, Kim K, Hwang S Front Endocrinol (Lausanne). 2023; 14:1044039.

PMID: 37181034 PMC: 10171108. DOI: 10.3389/fendo.2023.1044039.

Geographic Variations in Intertrochanteric Femoral Fractures in China.

Yang Q, Chen Y, Zhu D, Ai Z, Gao Y Biomed Res Int. 2019; 2019:8396723.

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Changing trends in the mortality rate at 1-year post hip fracture - a systematic review.

Downey C, Kelly M, Quinlan J World J Orthop. 2019; 10(3):166-175.

PMID: 30918799 PMC: 6428998. DOI: 10.5312/wjo.v10.i3.166.

The Adiponectin Paradox for All-Cause and Cardiovascular Mortality.

Menzaghi C, Trischitta V Diabetes. 2017; 67(1):12-22.

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References

Wiecek A, Adamczak M, Chudek J . Adiponectin--an adipokine with unique metabolic properties. Nephrol Dial Transplant. 2007; 22(4):981-8. DOI: 10.1093/ndt/gfl814. View

Panula J, Pihlajamaki H, Mattila V, Jaatinen P, Vahlberg T, Aarnio P . Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord. 2011; 12:105. PMC: 3118151. DOI: 10.1186/1471-2474-12-105. View

Uetani E, Tabara Y, Kawamoto R, Onuma H, Kohara K, Osawa H . CDH13 genotype-dependent association of high-molecular weight adiponectin with all-cause mortality: the J-SHIPP study. Diabetes Care. 2013; 37(2):396-401. DOI: 10.2337/dc13-1658. View

Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M . Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001; 24(4):683-9. DOI: 10.2337/diacare.24.4.683. View

Bornstein S, Licinio J, Tauchnitz R, Engelmann L, Negrao A, Gold P . Plasma leptin levels are increased in survivors of acute sepsis: associated loss of diurnal rhythm, in cortisol and leptin secretion. J Clin Endocrinol Metab. 1998; 83(1):280-3. DOI: 10.1210/jcem.83.1.4610. View

Khan M, Hossain F, Ahmed I, Muthukumar N, Mohsen A . Predictors of early mortality after hip fracture surgery. Int Orthop. 2013; 37(11):2119-24. PMC: 3824905. DOI: 10.1007/s00264-013-2068-1. View

Lehtonen A, Huupponen R, Tuomilehto J, Lavonius S, Arve S, Isoaho H . Serum testosterone but not leptin predicts mortality in elderly men. Age Ageing. 2008; 37(4):461-4. DOI: 10.1093/ageing/afn048. View

Gulcelik N, Bayraktar M, Caglar O, Alpaslan M, Karakaya J . Mortality after hip fracture in diabetic patients. Exp Clin Endocrinol Diabetes. 2011; 119(7):414-8. DOI: 10.1055/s-0030-1270466. View

Kistorp C, Faber J, Galatius S, Gustafsson F, Frystyk J, Flyvbjerg A . Plasma adiponectin, body mass index, and mortality in patients with chronic heart failure. Circulation. 2005; 112(12):1756-62. DOI: 10.1161/CIRCULATIONAHA.104.530972. View

10.

Soderberg S, Colquhoun D, Keech A, Yallop J, Barnes E, Pollicino C . Leptin, but not adiponectin, is a predictor of recurrent cardiovascular events in men: results from the LIPID study. Int J Obes (Lond). 2008; 33(1):123-30. DOI: 10.1038/ijo.2008.224. View

11.

Singer J, Palmas W, Teresi J, Weinstock R, Shea S, Luchsinger J . Adiponectin and all-cause mortality in elderly people with type 2 diabetes. Diabetes Care. 2012; 35(9):1858-63. PMC: 3424994. DOI: 10.2337/dc11-2215. View

12.

Gulin T, Kruljac I, Kirigin L, Merc M, Pavic M, Tominac Trcin M . Advanced Age, High β-CTX Levels, and Impaired Renal Function are Independent Risk Factors for All-Cause One-Year Mortality in Hip Fracture Patients. Calcif Tissue Int. 2015; 98(1):67-75. DOI: 10.1007/s00223-015-0070-x. View

13.

Kerby J, Griffin R, MacLennan P, Rue 3rd L . Stress-induced hyperglycemia, not diabetic hyperglycemia, is associated with higher mortality in trauma. Ann Surg. 2012; 256(3):446-52. DOI: 10.1097/SLA.0b013e3182654549. View

14.

Koch A, Sanson E, Voigt S, Helm A, Trautwein C, Tacke F . Serum adiponectin upon admission to the intensive care unit may predict mortality in critically ill patients. J Crit Care. 2010; 26(2):166-74. DOI: 10.1016/j.jcrc.2010.07.015. View

15.

Arnalich F, Lopez J, Codoceo R, Jim nez M, Madero R, Montiel C . Relationship of plasma leptin to plasma cytokines and human survivalin sepsis and septic shock. J Infect Dis. 1999; 180(3):908-11. DOI: 10.1086/314963. View

16.

Forsblom C, Thomas M, Moran J, Saraheimo M, Thorn L, Waden J . Serum adiponectin concentration is a positive predictor of all-cause and cardiovascular mortality in type 1 diabetes. J Intern Med. 2011; 270(4):346-55. DOI: 10.1111/j.1365-2796.2011.02406.x. View

17.

Ku I, Farzaneh-Far R, Vittinghoff E, Zhang M, Na B, Whooley M . Association of low leptin with cardiovascular events and mortality in patients with stable coronary artery disease: the Heart and Soul Study. Atherosclerosis. 2010; 217(2):503-8. PMC: 3085109. DOI: 10.1016/j.atherosclerosis.2010.10.047. View

18.

Engeli S, Feldpausch M, Gorzelniak K, Hartwig F, Heintze U, Janke J . Association between adiponectin and mediators of inflammation in obese women. Diabetes. 2003; 52(4):942-7. DOI: 10.2337/diabetes.52.4.942. View

19.

Wolk R, Berger P, Lennon R, Brilakis E, Johnson B, Somers V . Plasma leptin and prognosis in patients with established coronary atherosclerosis. J Am Coll Cardiol. 2004; 44(9):1819-24. DOI: 10.1016/j.jacc.2004.07.050. View

20.

Bian X, Liu N, Bai Y, Zheng L, He P, Su X . Association of leptin with mortality in patients on maintenance hemodialysis: a prospective study. Iran J Kidney Dis. 2014; 8(4):314-20. View