Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the National Health Insurance claims data

<p>Abstract</p> <p>Background</p> <p>The lack of epidemiologic information on osteoporotic hip fractures hampers the development of preventive or curative measures against osteoporosis in South Korea. We conducted a population-based study to estimate the annual incidence of hip fractures. Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations.</p> <p>Methods</p> <p>The Korean National Health Insurance (NHI) claims database was used to identify the incidence of hip fractures, defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation during 2003. The 6-month period prior to 2003 was set as a 'window period,' such that patients were defined as incident cases only if their first record of fracture was observed after the window period. Cox's proportional hazards model was used to investigate the relationship between survival time and baseline patient and provider characteristics available from the NHI data.</p> <p>Results</p> <p>The age-standardized annual incidence rate of hip fractures requiring operation over 50 years of age was 146.38 per 100,000 women and 61.72 per 100,000 men, yielding a female to male ratio of 2.37. The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group. The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals.</p> <p>Conclusion</p> <p>This national epidemiological study will help raise awareness of osteoporotic hip fractures among the elderly population and hopefully motivate public health policy makers to develop effective national prevention strategies against osteoporosis to prevent hip fractures.</p

Calcium and Phosphorus metabolism during Methylprednisolone puls therapy

Abstract: Intravenous glucocorticoid pulse therapy is a common treatment for immunologically origin diseases but it can not be considered a completely benign treatment. The effects of long term administration of glucocorticoids on calcium and phosphorus metabolism are well known, but less is known a bout the effect of pulse therapy. The purpose of this study was to investigate the effect of methylprednisolone pulse therapy on serum and urinary calcium and phosphorus and serum parathormone. In this prospective study 40 patients who received methylprednisolone pulse therapy for different reasons were investigated. Patients with renal insufficiency and those taking medications affecting calcium and phosphorus metabolism were excluded. Serum calcium, phosphorus, parathormone, creatinine and urinary calcium, phosphorus, and creatinine were measured before pulse therapy and in three consecutive days after treatment. This intervention had no effect on serum calcium, parathormone and urinary calcium. Serum phosphorus decreased with a nadir on the second day and urinary phosphorus increased. It was concluded that glucocorticoid pulse therapy directly increases renal phosphorus excretion, but calcium metabolism is not disturbed. Keywords: Glucocorticoid, Methylprednisolone puls therapy, Calcium, Phophorus, Parathormo

Effect of brewer’s yeast supplementation on serum glucose and lipids in type II diabetic patients with dislipidemia

Background and purpose : Chromium deficiency leads to impaired glucose and lipid metabolism. Chromium supplementation in type II diabetic patients improves glucose and lipid profiles. Organic chromium, such as found in brewer’s yeast, is much better absorbed than inorganic chromium. In this study, the effect of chromium supplementation in the form of brewer’s yeast on glucose and lipid profile of diabetic patients were evaluated.Materials and methods : In a clinical trial study (before and after) forty (32 women and 8 men) dyslipidemic diabetic patients without liver and cardiovascular diseases, 40-68 years old and BMI ³ 28 were randomly selected. Each patient received brewer’s yeast tablets containing 14.4 microgram chromium per day for 4 and 8 weeks. Fasting blood glucose, total cholesterol, HDL-C, LDLC and triglycerides were measured at the beginning and the end of 4 and 8 weeks after consumption of brewer’s yeast. A 24 hr dietary recall before and 4 and 8 weeks after consumption of brewer’s yeast were analyzed using Nutrition III software. Data were compared using paired t-test and x2-test as appropriate.Results : There were no statistical significant changes in body weight, BMI, energy and macronutrient intake before and after brewer’s yeast tablet. Mean total cholesterol (p<0.05) and fasting blood sugar levels (p<0.04) were significantly decreased after 8 weeks consumption of brewer’s yeast tablets. Mean LDLC and triglyceride level were significantly (p<0.001) decreased after 4 and 8 weeks consumption of brewer’s yeast tablets. Mean HDLC level was significantly (p<0.001) increased after 4 and 8 weeks consumption of brewer’s yeast tablets. An negative relationship was found between total cholesterol, LDLC, HDLC and TG of primary concentration and percentage of changes during study for each parameters.Conclusion : Improved glucose and lipid profile was noted in patients following 4 and 8 weeks consumption of brewer’s yeast tablets containing 14.4 microgram chromium per day. Also low chromium levels in diabetic patients,prevents diabetic patient from cardiovascular disease