Biochemical markers as predictors of hip fractures in elderly individuals with sarcopenia

Abstract

Purpose: Sarcopenia causes numerous senior hip fractures. The aim of the study is to investigate the effect of fracture type on hip function, clinical morbidity, and sarcopenia. Postoperative risk variables and prognosis were studied for surgically treated sarcopenic hip fractures.Materials and methods: Skelatal Mass Index (SMI), Total Psoas Area Index (TPAI), and serum dickkopf-related protein-1 (DKK-1) and sclerostin (SOST) were compared. In this single-center study, patients with proximal femur fractures treated at a tertiary trauma hospital between January 1, 2020, and March 1, 2021 were analyzed. Prospective 26-patient sarcopenic pertrochanteric/femoral neck fracture study. Our study included 52 patients (mean age 76.80±9.96 years, 27 males, 25 women). Preoperative lumbar and pelvic CT scans, TPAI, DKK-1, and SOST biochemical markers, postoperative DEXA, and SMI were included. Clinical follow-up assessed walking speed, Harris Hip Score (HHS), and Oxford Hip Score (OHS).Results: SMI was 5.65±0.98 kg/m² in group 1 and 4.88±0.79 in group 2 (p=0.009). The mean TPAI was 488.58±39.87 mm²/m² for group 1 and 455.92±44.3 for group 2 (p=0.007). Total DKK1 mean: 776.4286±577.50 pg/mL. The mean SOST was 1787.80±1262.01 pg/mL. SOST and DKK1 correlate (r=0.27, p=0.054). Group 1 had a mean OHS value of 29.81±4.23 post-op, while Group 2 had 28.85±3.76 (p=0.391). Group 1 had a mean HHS value of 63.27±10.88, while Group 2 had 64.15±7.34. The difference between groups in HHS was not significant (p=0.733). A link exists between OHS and HHS (r=0.79, p<0.001). Gait speed test showed not significant group differences.Conclusion: Femoral neck fracture patients with equal muscle mass may have better functional results, while those with less are at danger. Hip fractures in sarcopenia may elevate DKK1 and SOST.