Changes in Markers of Bone Metabolism Following Surgery
Daniela Klitscher, Markus Herrmann, Johannes Frank, Ingo Marzi, Wolfgang Herrmann and Gerhard Oremek
Affiliation: Department of Laboratory Medicine, University Hospital Frankfurt, Theodor- Stern- Kai 7, D- 60590 Frankfurt/Main, Germany.
Keywords: Abdominal surgery, bone alkaline phosphatase, fracture, hip arthroplasty, osteocalcin, type I collagen, C-terminal telopeptide, bone metabolism
The aim of the study was to investigate bone metabolism after surgery through monitoring of bone turnover markers up to 1 year. Samples from 58 patients with diaphyseal fractures of the lower leg or tibia (group 1, n = 13), pertrochanteric femur fractures (group 2, n = 10), medial femoral neck fractures treated by cemented hip hemiarthroplasty (group 3, n = 13), soft tissue diseases (group 4, n = 12) and in patients who underwent abdominal surgery (group 5, n = 10) were analyzed. We measured serum bone alkaline phosphatase (BAP) and osteocalcin (OC) as markers of bone formation and serum type I collagen C-terminal telopeptide (ßCTX) as marker of bone degradation. We found a significant decrease of BAP in all groups within the first week after surgery. Potential mediators, responsible for this early decrease are cytokines of the acute phase response. After an initial fall, serum concentration of the degradation marker ßCTX increased at 10 - 14 days depending on group, while bone formation markers started to rise later. The increase of markers of bone metabolism seems to reflect bone resorption and bone remodeling initiated by the surgical procedure and damage to the bone. Markers of bone metabolism provide a new and promising tool for monitoring fracture and hip replacement. Here, we present a review of recent patents and markers of bone metabolism provide a new and promising tool for monitoring fracture and hip replacement.
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