Serum calcium level – A sensitive predictor of risk of fragile hip fracture in elderly Indian population
Journal Title: Medpulse International Journal of Orthopedics - Year 2017, Vol 4, Issue 3
Abstract
Background: Skeletal system is considered to be the internal construct of the human body and Calcium is the major component of it. Calcium exists as insoluble inorganic salts with phosphorous in the bone, aiding the mineralisation of the osteoid matrix thereby imparting strength and resistance to stress and deforming forces. Extra skeletal calcium gets circulated in the body performing multiple physological activities. Human physiology has always given prime importance to these vital functions and maintains a near constant serum calcium levels within a narrow range. Any change in this level is discussed to cause resorption of the bone primarily and release the calcium stores, making it weak and elastic which makes them susceptible to fragile fractures. This study focuses on the predictive value of serum calcium to identify the risk of fragile hip fracture. Aim of the study: To estimate the serum calcium levels in elderly patients with hip fractures and compare them with that of the age matched control subjects and evaluate the relation between serum calcium level and fragile hip fractures. Materials and Methods: This is a prospective, case-control study conducted at Sri Ramachandra University, Chennai between July 2015 and July 2017. All the patients in the study are older than 65 years. The total sample of the study is 200 individuals (male - 73; female - 127) of which 100 patients (male – 37; female – 63 ) are with fragile hip fractures (neck of femur and Intertrochanteric) form the cases group and the other 100 patients form the control group ( male – 36 ; female – 64 ) who are age matched individuals without fragile hip fractures at the time of assessment. Patients younger than 65 years, with history of prior calcium supplementation, chronic steroid users, anti epileptic and anti malignant drug users, with history of chronic liver and kidney failure, malabsorption syndrome are excluded. Serum calcium is estimated from the individuals of both the groups and subjected to statistical analysis. Results: The mean value of serum calcium of the total sample is 8.995mg/d; (0.7670 S.D). The mean values of serum calcium in the case and control groups are 8.777mg/dl (0.7384 S.D) and 9.213mg/dl (0.7358 S.D) respectively. The mean serum calcium level is comparatively lesser in the patients with fragile hip fractures. There is a statistically significant difference between the serum calcium levels of both the groups (p=0.000). Conclusion: Low serum calcium level has a direct relation with the increased chance of developing a fragile hip fracture in elderly population. Serum Calcium may be considered as a sensitive predictor of the risk of a fragile hip fracture.
Authors and Affiliations
Gadde Saikrishna, V Ramnarayan, M Mohan Kumar
Keywords
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