PO:20:012 | Inflammatory markers and nutritional status in patients with osteoporotic fractures: preliminary analysis of a pilot study

Domenico Birra¹, Manuela Maione², Carolina Bologna¹, Carmela Pierce², Paolo Tirelli¹, Gianluigi Cuomo¹, Carolina Sepe², Pasquale Madonna¹, Claudio De Luca¹, Federica Coretti², Vincenzo Nuzzo¹ | ¹S.C. Reumatologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy; ²U.O.S.D. Malattie Endocrine del ricambio e della nutrizione - P. O. Ospedale del Mare - Asl Napoli 1 centro, Napoli, Italy 

Background. Chronic inflammation and malnutrition are emerging risk factors for bone fragility. This pilot study was designed to examine associations between inflammatory markers (ESR, CRP), nutritional status (albumin, total proteins), and metabolic parameters in patients with fragility fractures compared to non-fractured subjects.

Materials and Methods. We enrolled 120 consecutive patients (12 men, 108 women), including 40 with fragility fractures. Data were collected on ESR, CRP, albumin, total proteins, liver, and hormonal profiles. Fractures were categorized as vertebral, femoral, and other sites. Non-parametric tests were used; significance was set at p<0.05.

Results. Fracture patients had lower body weight (62±6 vs. 66±11 kg; p=0.017) and higher ESR and CRP (ESR 24±22 vs. 14±8; p=0.007; CRP 3.9±3 vs. 2.6±2.4; p=0.046). Vertebral fractures showed higher inflammation (ESR 25±21; CRP 4.5±3) and increased platelets (p=0.026). Other fractures had elevated CRP (4.9±2.7; p=0.016), liver enzymes (GammaGT 27.6±25; p=0.004), and calcitonin (1.8±1.5; p<0.001), with reduced albumin (4.1±0.3; p=0.04) and total proteins (6.2±0.67; p=0.013).

Discussion. Systemic inflammation is associated with fragility fractures, especially vertebral. Fractures at other sites show nutritional and metabolic alterations, suggesting different mechanisms. These findings support multidimensional risk assessment and further studies in larger cohorts.