Abstract
Study designProspective cohort study.ObjectiveTo study associations between specific bone turnover markers and fall-related fractures in individuals with spinal cord injury (SCI).SettingRehabilitation Hospital.MethodsCarboxy terminal collagen crosslinks (CTX), type-1 procollagen N-terminal (P1NP), albumin-corrected calcium (Ca2+), parathyroid hormone (PTH) and vitamin D were examined in a cohort of 106 participants with SCI at least 1 year post injury. The participants were followed for 1 year monitoring fall-related fractures.ResultsIn total, 29 out of 106 reported having experienced a fall-related fracture post-injury at baseline, and 5 out of 100 had experienced a fall-related bone fracture during the 1 year follow-up. Our main findings were that high levels of serum CTX increased the odds of being in the fracture group, and that 25-hydroxy vitamin D (25 OHD) levels, Ca2+, PTH or P1NP were not associated with being in the fracture group.ConclusionsWe here present an association between high-CTX plasma levels at baseline and fall-related fractures reported during a 1-year follow-up among individuals with established SCI. We recommend studies with larger SCI populations before further clinical implications can be drawn.
Highlights
Paralysed muscles and diminished vertical load on bones below the neurological level of injury result in extensive bone loss early after a spinal cord injury (SCI). This results in an accelerated condition of osteopenia or osteoporosis and is a frequent cause of bone fractures among individuals with established SCI [1,2,3,4]
Sixty-two participants were defined as wheelchair users and 44 as ambulatory
We found no association between P1NP, Ca2+, parathyroid hormone (PTH) and acquired fractures during the 1-year follow-up
Summary
Paralysed muscles and diminished vertical load on bones below the neurological level of injury result in extensive bone loss early after a spinal cord injury (SCI). There is no data on whether high CTX levels predict fractures in individuals with SCI, or evidence concerning optimal vitamin D status after an SCI, and their association with fractures after SCI. Such data could be of value in clinical practice to identify those at risk. The aim was to determine if specific bone turnover markers can be used to predict fall-related fractures
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