Obesity-related metabolic and endocrine disorders diagnosed during postoperative follow-up of slipped capital femoral epiphysis

Abstract

Background and purposePatients with slipped capital femoral epiphysis (SCFE) are phenotypically overweight or obese and may therefore require clinical follow-up of obesity-related disorders. We evaluated obesity-related disorders such as dyslipidemia, type 2 diabetes mellitus (DM), and vitamin-D deficiency during the postoperative period in patients with SCFE.Patients and methods51 patients who were operated and followed-up for SCFE and 62 healthy adolescents without SCFE (control group) were included in this retrospective study. Patients’ BMI, serum lipid profile (total cholesterol, LDL-C, HDL-C, triglyceride), fasting blood glucose, HbA1c, and serum vitamin D levels were evaluated.ResultsAt the time of surgery, 45 patients in the SCFE group were overweight or obese (BMI >25). At the latest follow-up, 42 patients in the SCFE group and 53 patients in the control group were overweight/obese. Abnormal serum lipid profile and ratio of total dyslipidemia were similar between the groups. 8 patients had abnormal HbA1c levels in the SCFE group and mean HbA1c levels were significantly higher in the SCFE group (p = 0.03). All patients and controls had low levels of vitamin D.InterpretationAlthough serum lipid profile and vitamin D levels were detected as similar in SCFE and control groups, the potential risk of type 2 DM identified via abnormal HbA1c levels was significantly higher in patients with SCFE. We recommend that patients diagnosed with SCFE should be considered as potential candidates for type 2 DM; thus follow-up after surgical treatment should include not only orthopedic outcomes but also evaluation of future risk for DM.

No increased mortality after total hip arthroplasty in patients with a history of pediatric hip disease: a matched, population-based cohort study on 4,043 patients

“…Nevertheless, in the group of patients with a pediatric hip disease leading to THA we found a higher proportion of cardiovascular deaths and a lower proportion of cancer-related deaths than in the group of unexposed individuals. The underlying mechanism remains unclear, but a plausible reason could be the increased incidence of cardiovascular diseases in patients with LCPD and SCFE described in previous studies (Hailer et al 2010, Ucpunar et al 2018). On the other hand, patients with primary OA of the hip or knee have an increased risk of cardiovascular deaths (e.g., chronic ischemic heart disease and heart failure) (Gordon et al 2016, Turkiewicz et al 2019).…”

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

“…SCFE is one of the most common hip disorders in children that can lead to lifelong impairment of hip function. Associations between SCFE and obesity and hypothyroidism have been described but many studies used a retrospective design and small cohorts (Bhatia et al 2006 , Ucpunar et al 2018 ). In the past years reports from national databases have increased (Murray and Wilson 2008 , Herngren et al 2017 , Perry et al 2017 , Ravinsky et al 2019 ), making it possible to analyze epidemiological characteristics of different disease conditions.…”

“Slipped capital femoral epiphysis in a 25-year-old hypogonadic man with a large cranial chondroma: causality or coincidence? “

“…Another fact that makes the described case unique is that SCFE mainly occurs in obese patients [ 3 , 4 ], while our patientBMI was 22.05 kg / m2, which is the desired body weight.…”

“…Incorrect distribution of forces working on the proximal part of the femur, relative and absolute retroversion of the femoral neck are identified as potential mechanical factors which cause SCFE. Obesity [ 3 – 5 ], endocrine disorders (hypothyroidism, hypopituitarism, hypoparathyroidism) [ 5 , 6 ], genetic disorders [ 7 , 8 ] and growth hormone therapy are potential causes of epiphyseal cartilage injury. Slipped capital femoral epihysis in adults is very rare.…”