K. Ng et al., SECONDARY HYPERPARATHYROIDISM, VITAMIN-D DEFICIENCY AND HIP FRACTURE - IMPORTANCE OF SAMPLING TIMES AFTER FRACTURE, Bone and mineral, 25(2), 1994, pp. 103-109
There is controversy about how often elevated parathyroid hormone (PTH
) levels are found in hip fracture patients. The aim of this study was
to determine whether changes in PTH levels after fracture and surgery
could explain some of the variation in published data. Blood samples
were obtained from 24 elderly patients with hip fracture before surger
y, immediately after surgery and at 2 weeks and 3 months after fractur
e. PTH levels were elevated (>5.5 pmol) in 33% initially and then fell
significantly at 2 weeks in virtually all subjects (P < 0.001) and re
mained significantly lower after 3 months (n = 17). Although 25-hydrox
yvitamin D levels were low (< 30 nmol) in 44% of the patients, the fal
l in PTH was not explained by alterations in vitamin D metabolites or
other measured parameters. The cause of the variation in PTH levels is
unknown but measurements immediately after fracture could overestimat
e the incidence of secondary hyperparathyroidism. Vitamin D deficiency
is common in our hip fracture population and is not influenced by hos
pitalisation.