Oxidative stress markers and trace element levels in patients with hip fracture

Abstract

Introduction: Osteoporosis is a condition causing bone resorption and hip fractures (HF) in the elderly. Oxidative stress (OS) plays a role in the pathogenesis of osteoporosis. Levels of the trace elements copper (Cu), selenium (Se), and zinc (Zn) have been shown to affect bone structure, and are cofactors of the enzymes of bone metabolism. Materials and methods: Red blood cell (RBC) levels of malondialdehyde (MDA) and reduced glutathione (GSH) as well as plasma levels of Cu, Se, and Zn were measured preoperatively and on the second day after the surgery in 51 HF patients. The levels of these analytes were compared with 51 age-matched healthy controls. The levels of these OS parameters and trace elements were compared according to survival status. Results: Significantly higher MDA levels, as an indicator of lipid peroxidation, were seen in the patient group on the preoperative and second days after the surgery (p = 0.05: p < 0.001, respectively). The GSH levels were lower preoperatively and on the second day after the surgery compared to the baseline (p < 0.0001; p < 0.0001. respectively). Se and Zn levels were lower in the postoperative period as compared to the preoperative period (p = 0.04; p < 0.0001, respectively). The overall mortality of our study group within 2 years was 35.3%. Preoperative Cu levels were found to be significantly higher in the surviving HF patients. Conclusion: We demonstrated an association between OS markers and HF in our study group. We also suggest that deteriorated trace element status in the HF patients is related to the occurrence of HF incidents, and might be related to the mortality following HF surgery.