Is the Mean Platelet Volume Predictive of Hip Fractures in the Elderly?

Mean platelet volume (MPV) reflects the size of platelets and is accepted as a marker of platelet function. Platelets secrete and express a large number of substances that are crucial mediators of coagulation, inflammation, thrombosis, and atherosclerosis [1]. Hip fractures in the elderly are associated with impaired mobility and increased morbidity and mortality. Chronic disease has one of the most potentially harmful impacts on bone health in the elderly. The detrimental factors involved in chronic diseases are often multifactorial, including poor nutrition, diminished physical activity, inflammatory cytokine exposure, and/or medications [2, 3]. These factors lead to reduced bone mineralization and increased osteoporosis, which is marked by decreased density of the bone infrastructure, leading to a decrease in overall bone strength. In this study, we investigated whether fractures in the femur neck and intertrochanteric region are related to MPV. Patients above the age of 65 who were treated for femur neck or intertrochanteric region fractures between 2006 and 2012 were screened in this study. Exclusion criteria were as follows: a fracture due to a traffic accident or other major trauma and femur fractures in other regions. A total of 102 patients were included in the femur neck group, and 95 patients were included in the intertrochanteric group. Ageand gender-matched control subjects (98 patients) without fractures were also enrolled. The study was performed according to the guidelines of the Helsinki Declaration and was approved by our local ethics committee. Hematologic tests were performed using CELL-DYN Ruby analyzer (Abbott Laboratories, Abbott Park, IL, USA). All biochemical tests were performed using Abbott Laboratories Architect C16000 analyzer (Abbott Laboratories). The data were analyzed using SPSS 13.1 for Windows (Chicago, IL, USA). Differences between the 2 groups were analyzed using an independent sample t-test. The differences were considered significant at P <0.05. The results for age, gender, and chronic diseases between the controls and patients are shown in Table 1. The mean MPV values for the femur neck and intertrochanteric region groups were significantly higher than those for the control group (Table 2). The mean Hb levels in the femur neck and intertrochanteric region groups were lower than that in the control group (11.0±1.5 g/dL, P <0.001; 11.7±1.7 g/dL, P =0.007; 12.4±1.4 g/dL, respectively). The femur neck, intertrochanteric, and control groups were further divided into subgroups depending on the presence of chronic diseases such as diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease, chronic renal failure, and