Quantitative heel ultrasonography, 25-hydroxyvitamin D, and urine amino-terminal cross-linking telopeptide of type I collagen in patients with a recent hip fracture

Objective. This study examined quantitative heel ultrasonography (QUS), 25-hydroxyvitamin D (25-OHD) levels, and urine amino-terminal cross-linking telopeptide of type I collagen (NTX-I) levels in patients with a recent osteoporotic hip fracture to see whether they were clinically useful. Methods. Stiffness index (SI) T scores from QUS, 25-OHD levels, and urine NTX-I levels were obtained in 53 female and 32 male patients with hip fractures. Sixty-five female patients and 5 male patients attending our geriatric clinic were used for comparison. Results. The SI T scores of the hip fracture patients were less than those of the geriatric clinic patients. The difference was significant in female patients (P = .0001) but not in male patients (P = .1). Serum levels of 25-OHD were less than 28 ng/mL in 50 of 59 patients and less than 5 ng/mL in 2 patients. Levels of urine NTX-I were variable and were not correlated with other parameters. Conclusions. Patients who have had a hip fracture have a low SI determined by QUS; this is easy to perform, and it provides a baseline T score from which to assess treatment effects. Most of these patients are vitamin D deficient, and measurement of the 25-OHD level would enable physicians to prescribe an appropriate dose of vitamin D. Urine NTX-I measured shortly after a hip fracture is not clinically helpful.