Prognostic biomarkers of low-energy fractures in older patients
Background: Low-energy fractures are common among elderly and senile patients, but the predictive ability of individual blood biomarkers in relation to these fractures remains poorly understood. The aim of the study:To identify prognostic biomarkers of low-energy fractures in older patients. Materials and methods: 112 patients 65 years of age and older with low-energy hip fractures and 109 patients 65 years of age and older with no fracture data were examined. Diagnosis of low-energy hip fractures was carried out according to medical history, complaints, objective clinical symptoms, and X-ray examination. Biochemical blood parameters were determined in the morning hours before meals by the content of glucose, hemoglobin, absolute number of lymphocytes, albumin, globulin, direct bilirubin, indirect bilirubin, creatinine, and cystatin C in the blood serum. Correlation, univariate, and multifactorial logistic regression analysis, and ROC analysis were used in statistical processing. Results: Among patients with low-energy hip fractures, the following biochemical parameters of the blood serum were statistically significant: albumin content up to 33.6±2.4 g/l (below normal limits), apolipoprotein A content up to 0.9±0.1 g/l, creatinine content up to 0.59±0.2 mg/l and indirect bilirubin content up to 11.3±1.2 mmol/l. However, in this group, compared with patients without low-energy hip fractures, the level of low-density lipoproteins (up to 2.76±0.7 mmol/l), serum cystatin C (up to 1.34±0.3 mg/l) and a reduced sarcopenia index to 44.0±3.8 (p<0.001) were significantly higher. Independent prognostic biomarkers in multifactorial logistic regression analysis revealed low levels of albumin, apolipoprotein A, creatinine, elevated serum cystatin C levels and a decreased sarcopenia index. The ROC analysis showed a high predictive ability of the sarcopenia index, the content of creatinine and cystatin C in blood serum with an area under the curve of 0.847; 0.821 and 0.809, respectively. Conclusion: Serum creatinine, cystatin C, apolipoprotein A, albumin, and sarcopenia index can be used as predictive biomarkers of low-energy hip fractures among older patients
Agarkov NM, Ibiev ASO, Fedoseev IM, et al. Prognostic biomarkers of low-energy fractures in older patients. Research Results in Biomedicine. 2026;12(3):511-525. Russian.
DOI: 10.18413/2658-6533-2026-12-3-1-0
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