Effects of protein-rich supplementation and nandrolone in lean elderly women with femoral neck fractures

Aim: To evaluate the effects of a protein-rich liquid supplementation, alone or in combination with the anabolic steroid nandrolone decanoate, on body composition, activities of daily living (ADL) status and the health-related quality of life (HRQoL) after a femoral neck fracture. Methods: Sixty women, aged 83±5 years (mean±SD), BMI<24 kg/m2 (20.4±2 kg/m2 ) and capable of co-operating, with a femoral neck fracture treated with internal fixation, were randomised to open treatment during 6 months with a protein-rich liquid formula alone (PR, Fortimel®, 200 ml/day, 20 g protein/day) or in combination with nandrolone decanoate (PR/N, Deca-Durabol® 25 mg i.m./3 weeks) or to a control group (C). The patients were re-examined after 6 and 12 months regarding body weight (BW), lean body mass (LBM, DXA), ADL status according to Katz, HRQoL according to EQ 5-D and fracture healing. Results: LBM decreased in the C (−1.2±2 kg) and PR groups (−1.2±1 kg) but remained the same in the PR/N group (0.3±1 kg) (P<0.05 between groups). ADL remained at a high level in the two intervention groups but declined significantly in the C group (P<0.005 between groups). The decline in HRQoL was least pronounced in the PR/N group at 6 months (P<0.05 between groups). Patients with fracture healing complications lost more BW (P<0.05) and LBM (P<0.01) than patients with uneventful fracture healing. Conclusion: Protein-rich liquid supplementation in combination with nandrolone given for 6 months to lean elderly women after a femoral neck fracture may positively affect LBM, ADL and HRQoL.