Abstract：
BACKGROUND: Hip fractures are the most common cause of hospital admission to orthopaedic departments in Europe and they generate a major health problem. Therefore, it is of great interest to identify additional risk factors that will help us to better understand the pathophysiology of these fractures and improve our preventive capacity. There is sufficient data to support the theory of modulation of bone mass by gut microbiota (osteomicrobiology); however, there is a lack of human clinical studies directly linking microbiota to hip fracture risk.
METHODS: Observational, analytical, case-control study. The sample consisted of 50 patients and it was distributed as follows: 25 elderly patients with fragility hip fracture and 25 subjects without fracture. The intestinal microbiota was determined by DNA extraction from stool samples and 16S ribosomal DNA sequencing after generation of gene libraries.
RESULTS: Alpha diversity revealed an elevation of the estimators for the taxonomic class level in the hip fracture group. The orders Bacteroidales, Oscillospirales, Lachnospirales, Peptostreptococcales-Tissierellales and Enterobacterales were the dominant orders in both groups. In patients with fracture, a significant percentage increase in the orders Bacteroidales (p<.001) and Peptostreptococcales-Tissierellales (p<.005) was observed, as well as a decrease in the orders Lachnospirales (p<.001) compared to controls.
CONCLUSIONS: This study has found an association between a specific microbiota in elderly patients with fragility hip fracture. These findings open the door to new strategies to prevent hip fractures. Modification of the microbiota through probiotics may prove to be an effective method to reduce the risk of hip fracture.
METHODS: Observational, analytical, case-control study. The sample consisted of 50 patients and it was distributed as follows: 25 elderly patients with fragility hip fracture and 25 subjects without fracture. The intestinal microbiota was determined by DNA extraction from stool samples and 16S ribosomal DNA sequencing after generation of gene libraries.
RESULTS: Alpha diversity revealed an elevation of the estimators for the taxonomic class level in the hip fracture group. The orders Bacteroidales, Oscillospirales, Lachnospirales, Peptostreptococcales-Tissierellales and Enterobacterales were the dominant orders in both groups. In patients with fracture, a significant percentage increase in the orders Bacteroidales (p<.001) and Peptostreptococcales-Tissierellales (p<.005) was observed, as well as a decrease in the orders Lachnospirales (p<.001) compared to controls.
CONCLUSIONS: This study has found an association between a specific microbiota in elderly patients with fragility hip fracture. These findings open the door to new strategies to prevent hip fractures. Modification of the microbiota through probiotics may prove to be an effective method to reduce the risk of hip fracture.
摘要：
背景：髋部骨折是欧洲骨科住院的最常见原因，并且会产生主要的健康问题。因此,我们非常感兴趣的是发现额外的危险因素,这将有助于我们更好地了解这些骨折的病理生理学,并提高我们的预防能力.有足够的数据支持肠道微生物群（骨微生物学）调节骨量的理论；然而，缺乏直接将微生物群与髋部骨折风险联系起来的人类临床研究.
方法：观察性，分析，病例对照研究。样本由50例患者组成，分布如下：25例老年脆性髋部骨折患者和25例无骨折患者。通过从粪便样品中提取DNA并在基因文库产生后进行16S核糖体DNA测序来确定肠道微生物群。
结果：Alpha多样性显示髋部骨折组的分类等级的估计量升高。拟杆菌订单，螺旋管,湖水螺旋藻,在两组中，肽链球菌和肠杆菌是优势菌种。在骨折患者中，一个显著的百分比增加，在顺序拟杆菌（p<0.001）和肽链球菌-Tissielellales（p<0.005）观察到，以及与对照组相比，夏氏螺旋藻顺序减少（p<0.001）。
结论：本研究发现老年脆性髋部骨折患者的特定微生物群之间存在关联。这些发现为预防髋部骨折的新策略打开了大门。通过益生菌改变微生物群可能被证明是降低髋部骨折风险的有效方法。
方法：观察性，分析，病例对照研究。样本由50例患者组成，分布如下：25例老年脆性髋部骨折患者和25例无骨折患者。通过从粪便样品中提取DNA并在基因文库产生后进行16S核糖体DNA测序来确定肠道微生物群。
结果：Alpha多样性显示髋部骨折组的分类等级的估计量升高。拟杆菌订单，螺旋管,湖水螺旋藻,在两组中，肽链球菌和肠杆菌是优势菌种。在骨折患者中，一个显著的百分比增加，在顺序拟杆菌（p<0.001）和肽链球菌-Tissielellales（p<0.005）观察到，以及与对照组相比，夏氏螺旋藻顺序减少（p<0.001）。
结论：本研究发现老年脆性髋部骨折患者的特定微生物群之间存在关联。这些发现为预防髋部骨折的新策略打开了大门。通过益生菌改变微生物群可能被证明是降低髋部骨折风险的有效方法。
