PANCREATIC ENDOCRINE AND EXOCRINE FUNCTION IN OSTEOPOROSIS IN ELDERLY PATIENTS WITH HIP FRACTURE

Abstract

Background: Malnutrition and osteoporosis common in elderly subjects and may be related pancreatic exocrine insufficiency, which may be due to pancreatitis. There are few studies to elucidate pancreatic functions in osteoporotic hip fracture patients. It is important to identify predictive markers for osteoporotic hip fractures. Aim: The aim of the study was to assess plasma C-peptide, as a marker of endocrine pancreatic function, and plasma pancreatic amylase and faecal elastase, as markers of exocrine function, in elderly patients with osteoporotic hip fracture. Methods and Material: 65-85 years with hip fractures were investigated. P-C-peptide, pancreatic amylase and fecal elastase were measured. The nutrition status were determined by BMI, P-albumin, IGF-1. Bone and body compositions were determined by DEXA. Results: 22 women and 8 men, with mean age of 78 were included. Fifteen patients had plasma C-peptide above reference. 6 had low plasma pancreatic amylase and one had a low faecal elastase. Low BMI, reduced IGF-1, and low albumin indicated a state of under nutrition.Bone mineral density was reduced in 29. C-peptide correlated negatively with pancreatic amylase and negative correlations between plasma C-peptide and the factors: nutrition status and bone mineral densities and positive between pancreatic amylase and same factors. Conclusion: Elderly patients with osteoporotic fractures had elevated plasma C-peptide and decreased plasma pancreatic amylase. Pancreatic functions were correlated to nutritional status and bone mineral density in these patients. Endocrine and exocrine pancreatic function may influence bone health in elderly and play a role in the pathogenesis of osteoporotic hip fracture. Further studies are needed.