Arm fractures followed soon by death

Photo provided by Andre van Schalkwyk of Antilogic

Photo provided by Andre van Schalkwyk of Antilogic

Broken arm? No problem! One trip to the hospital, and you’re ready to continue your long healthy life. Maybe not. University of Helsikinki’s very own have reported a strong link between upper limb fracture and increased rate of death.

Just shy of 6,000 people of Finland who sustained bone fractures to their upper extremities were followed for an average of six years between 2002 and 2012. Researchers wanted to find out if those with shoulder, arm, wrist, etc. fractures had an increased risk of death similar to those with hip fractures.

Previous studies have documented that people with one or more hip fractures have nearly a three times higher rate of dying than people of the same age without a hip fracture. The standardized mortality ratio (SMR) was 2.18 for women and 3.17 for men. The SMR is the amount of deaths of a studied population as compared to the general population. An SMR of 1 would mean an equal rate of death in both populations, while an SMR of 2 would mean 100% more cases of death in the studied population.

This study found that 12% of the studied population had died five years after their upper extremity fracture. For individuals between 16 and 59 years old, there were nearly 200% more cases of death for individuals with a bone fracture as compared to those without (SMR: 2.2 for women, 3.0 for men). Individuals 60 years of age and older had an average of 40% more cases of death (SMR: 1.2 for women, 1.6 for men). If the fracture was in the individual’s humerus, the arm bone that extends from shoulder to elbow, mortality was much higher for both sexes of all ages.

Leading causes of death for individuals sustaining upper limb fractures were cardiovascular disease, accidents, and violence. No, this does not mean a broken arm increases risk of heart attack (except in the mother of the son who broke his arm playing street hockey), but concern should be raised after sustaining fracture.

People who break an arm, or sustain similar upper extremity fractures, may be more frail than others, leading a risky lifestyle, or just unlucky. Whatever the reason, this study says be careful in the future and stay healthy!

Axel Somersaloa, Juha Palonevab, Hannu Kautiainencd, Eija Lönnroose, Mikko Heinänenf, Ilkka Kivirantaf. Increased mortality after upper extremity fracture requiring inpatient care. Acta Orthopaedica, 2015.

unOC linked to Diabetes relief

GLP-1 effects on different human organs.
Photo credits: Daniel J. Drucker (author of the paper of
DOI: 10.1016/j.cmet.2006.01.004)

Researchers have perhaps found another means by which to manage type 2 diabetes. A group from 九州大学 (Kyushu  University) has shown that addition of uncarboxylated osteocalcin (unOC) stimulates glucagon-like peptide-1 (GLP-1) release and insulin secretion in mice.

GLP-1 is normally released in released into the blood in response to eating, so that insulin can be released and digested glucose can be taken into cells. In those with type-II diabetes, the insulin release pathway is impaired in some way, so insufficient insulin (or no insulin) is produced to promote glucose uptake.

UnOC has shown in previous studies to have an effect on the pancreas directly to stimulate insulin release; therefore, this study wanted to test the indirect effect of unOC on insulin secretion via the GLP-1 pathway.

Using mice, unOC’s effect on GLP-1 secretion was tested. 20 minutes after giving mice unOC orally or intraperitoneally, a maximal rise of 50 pg/mL of serum GLP-1 was seen. However, this significant rise was only seen in mice also given the DPP-IV inhibitor sitgaliptin. This needed to be co-administered because GLP-1 has a very short half life and would breakdown before the effects could be seen.

Extending from this, the insulin levels in mice given unOC were seen as raised as well. With the combination of unOC and sitagliptin, insulin rose (maximally) 0.4 ng/mL. These results were seen administering therapies orally or via intrapineal injection. Administering intravenously gave similar results with significant rises in GLP-1 and insulin sooner (as expected).

This study shows unOC may be a strong therapy for type II diabetes management if given to patients in the pure chemical form, as an additive to food, or the like.

Akiko Mizokami, Yu Yasutake, Jing Gao, Miho Matsuda, Ichiro Takahashi, Hiroshi Takeuchi, Masato Hirata. Osteocalcin Induces Release of Glucagon-Like Peptide-1 and Thereby Stimulates Insulin Secretion in Mice. PLoS ONE, 2013.


A note from me:

Lately my writings have been sluggishly drawn out and without the wherewithal to inspire (not to mention I’ve been posting suuuuuper late). Because of this, I’m taking a week break from blogging. For those that follow: I’ll see you on March 1st. For those that stumbled upon this today: Hopefully you’ll muse my articles, learn some cool stuff, and come back in a week when I pick up again.

See you all seven mornings from now 🙂