Serum levels of Dickkopf-1 are a potential negative biomarker of survival in geriatric patients

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Fragility fractures due to osteoporosis and its most dreaded complication – hip fractures – are the cause of disability, high mortality and place a considerable burden on global health economics. Although much work has been done to accurately predict mortality and find risk factors for poor health outcome, little attention was given to the Wnt-catenin signaling pathway and its role in the posttraumatic course of disease. We studied 238 geriatric patients (175 women (mean age 84 yrs) and 63 men (mean age 82 yrs)) in total that were admitted to a department of Acute Geriatric Care. 150 out of these patients had suffered a hip fracture and 88 not. After discharge patients were followed up with an average follow-up time of 4.06 ± 1.07 yrs. The follow-up mortality rate was 15.7%. In an age- and sex-adjusted model, low serum levels of Dickkopf-1 (Dkk-1), an inhibitor of the canonical Wnt signaling pathway, were significantly associated with mortality. The strong association of Dkk-1 levels and mortality has clinical relevance as it suggests Dkk-1 to be a therapeutic target to improve survival after hip fractures.Graphical abstractDkk-1 is a potential negative biomarker for prognosis of survival of geriatric patients.HighlightsLow Dkk-1 levels, increased parathyroid hormone levels, elevated incidence of comorbidity, lower body mass index and a low Barthel Index are associated with higher mortality in a group of geriatric patients.This study emphasizes the potential of Dkk-1 as a negative biomarker for the prognosis of survival in a geriatric patient population after hip fractures.Dkk-1 is assumed to serve as a target for medical interventions.

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