pituitrin and Fractures--Bone

To assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.. We analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.. Overall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p<0.001) and MR-proANP (aHR: 1.23, 95% CI 1.05 to 1.45, p<0.001) were independently associated with increased risk of any fracture. The fracture risk increased linearly across MR-proANP quartiles. Individuals who were in the top quartile of all four biomarkers had a significant higher risk of fracture at any site (aHR: 2.32, 95% CI 1.86 to 2.91), vertebral fracture (aHR: 3.16, 95% CI 1.97 to 5.07) and femoral fracture (aHR: 2.35, 95% CI 1.64 to 3.36).. Elevated levels of MR-proADM and MR-proANP independently predict fragility fractures in older adults. In subjects with top quartile levels of all four biomarkers there is a twofold to threefold increase in risk of vertebral and femoral fractures.

Topics: Adrenomedullin; Aged; Atrial Natriuretic Factor; Biomarkers; Body Mass Index; Cardiovascular System; Cohort Studies; Correlation of Data; Endothelin-1; Female; Fractures, Bone; Humans; Independent Living; Male; Middle Aged; Peptide Fragments; Prospective Studies; Protein Precursors; Reproducibility of Results; Risk Assessment; Risk Factors; Sweden; Vasopressins

The authors discuss about five cases of diabetes insipidus observed in patients affected by traumatic cervical spine fractures and/or dislocations, without either evident lesions of the cerebral structures at CT scan examination, or important craniocerebral trauma. In all patients polyuria and hyperthermia arose some days after the traumatic accident and regressed spontaneously or after exogeneous vasopressin administration. Vasopressin urinary levels confirmed the presence of a true diabetes insipidus, the origin of which is in largely obscure. A central medullary vasopressin mediated pathway, demonstrated only in experimental animals, may be responsible for such a finding.

Topics: Adolescent; Adult; Cervical Vertebrae; Diabetes Insipidus; Female; Fever; Fractures, Bone; Humans; Hypothalamo-Hypophyseal System; Joint Dislocations; Male; Polyuria; Radiography; Spinal Cord Injuries; Syndrome; Vasopressins

Topics: Adult; Body Water; Brain Injuries; Diabetes Insipidus; Facial Injuries; Female; Fractures, Bone; Humans; Hyponatremia; Hypothalamus; Male; Natriuresis; Osmolar Concentration; Pituitary Gland, Posterior; Prospective Studies; Skull Fractures; Sodium; Vasopressins

Topics: Animals; Bone Regeneration; Fractures, Bone; Glycosaminoglycans; Hexosamines; Histological Techniques; Injections, Subcutaneous; Lysine; Methods; Microscopy, Polarization; Rats; Staining and Labeling; Time Factors; Vasopressins

Topics: Animals; Biometry; Bone Regeneration; Femoral Fractures; Fractures, Bone; Glycosaminoglycans; Lysine; Microscopy, Polarization; Proteins; Rats; Vasopressins

Topics: Animals; Biometry; Bone Regeneration; Fractures, Bone; Lysine; Rats; Vasopressins

Topics: Animals; Cartilage; Collagen; Fractures, Bone; Glycosaminoglycans; Hexosamines; Microscopy, Polarization; Osteogenesis; Rats; Vasopressins; Wound Healing

Topics: Animals; Femoral Fractures; Fractures, Bone; Rats; Vasopressins; Wound Healing