Povezanost leptina i adiponektina sa smrtnošću tijekom prve godine nakon osteoporotskog prijeloma proksimalnog femura [Association of leptin and adiponectin with one year mortality after osteoporotic fracture of the proximal femur]

Abstract

Osteoporotic fracture of the proximal femur is a serious injury that results in significant impairment of functional status and decreased life expectancy. Leptin and adiponectin are a part of a adipocytokines family - which are hormones secreted by adipocytes. Numerous studies have examined their impact on mortality both in general and specific populations, but none of them was conducted in patients with hip fracture. The aim of this study was to determine the influence of leptin and adiponectin, as well as routine laboratory and antropomethric parameters on mortality during the first year after osteoporotic fractures of the proximal femur. A total of 236 consecutive patients (59 males) with hip fractures were followed over a one-year period. Patient age, gender, type of fracture, type of treatment, time from admission to surgery, type of anaesthesia, body mass index (BMI), and electrocardiograms were recorded. Routine preoperative laboratory tests including osteocalcin and beta-crosslaps were masured at admission. On the last day of hospitalization, the blood sample was taken and serum was separated and stored at -80 ° C. Later, that serum was used to determine adiponectin, insulin and leptin concentrations. One year after the fracture mortality rate was 28.4%. Older patients had higher mortality regardless of other parameters (HR 1.111, 95% CI 1:07 to 1:16, P <0.001). Male gender was a risk factor for mortality (OR 2.88, 95% CI 1:35 to 6:11, P = 0.006). Low albumin levels (P=0.46, HR 0,949, 95% CI 0,902-0,999), high adiponectin (P=0,022, HR 1,063, 95 % CI 1.009-1.120) and high β-cross laps levels (P=0,001, HR 4,632, 95%CI 1.874-11.452) were independent predictors of mortality within the first year after the fracture. There was no correlation between leptin and one-year mortality. In summary, gender, age, albumin, adiponectin and beta-crosslaps are independent predictors of one-year mortality in patients with fractures of the proximal femur