Journal article
Inflammatory markers and the risk of hip fracture: The women's health initiative
Journal of bone and mineral research, Vol.27(5), pp.1167-1176
05/01/2012
DOI: 10.1002/jbmr.1559
PMCID: PMC3361578
PMID: 22392817
Abstract
Cytokines play a major role in bone remodeling in vitro and in animal models, with evidence supporting the involvement of inflammatory markers in the pathogenesis of osteoporosis. However, less is known about the longitudinal association of inflammatory markers with hip fracture. We tested whether high receptor levels of proinflammatory cytokines are associated with an increased risk of hip fracture in older women. We used a nested case-control study design from the Women's Health Initiative Observational Study (WHI-OS) and selected 400 cases with physician-adjudicated incident hip fractures and 400 controls matched on age, race, and date of blood draw. Participants were chosen from 39,795 postmenopausal women without previous hip fractures, not using estrogens or other bone-active therapies. Incident hip fractures (median follow-up 7.1 years) were verified by review of radiographs and confirmed by blinded central adjudicators. Hip fractures with a pathological cause were excluded. In multivariable models, the risk of hip fracture for subjects with the highest levels of inflammatory markers (quartile 4) compared with those with lower levels (quartiles 1, 2, and 3) was 1.43 (95% confidence interval [CI], 0.982.07) for interleukin-6 (IL-6) soluble receptor (SR), 1.40 (95% CI, 0.972.03) for tumor necrosis factor (TNF) SR1, and 1.56 (95% CI, 1.092.22) for TNF SR2. In subjects with all three markers in the highest quartile, the risk ratio of fracture was 2.76 (95% CI, 1.226.25) in comparison with subjects with 0 or 1 elevated marker(s) (p trend?=?0.018). Elevated levels of inflammatory markers for all three cytokine-soluble receptors were associated with an increased risk of hip fractures in older women. Future clinical trials should test whether interventions to decrease inflammatory marker levels reduces hip fractures. (c) 2012 American Society for Bone and Mineral Research.
Details
- Title: Subtitle
- Inflammatory markers and the risk of hip fracture: The women's health initiative
- Creators
- Kamil E. Barbour - University of PittsburghRobert Boudreau - University of PittsburghMichelle E. Danielson - University of PittsburghAda O. Youk - University of PittsburghJean Wactawski-Wende - University at Buffalo, State University of New YorkNancy C. Greep - Saint John's Health CenterAndrea Z. LaCroix - Fred Hutch Cancer CenterRebecca D. Jackson - The Ohio State UniversityRobert B. Wallace - University of IowaDouglas C. Bauer - Fred Hutch Cancer CenterMatthew A. Allison - University of California SystemJane A. Cauley - University of Pittsburgh
- Resource Type
- Journal article
- Publication Details
- Journal of bone and mineral research, Vol.27(5), pp.1167-1176
- DOI
- 10.1002/jbmr.1559
- PMID
- 22392817
- PMCID
- PMC3361578
- NLM abbreviation
- J Bone Miner Res
- ISSN
- 0884-0431
- eISSN
- 1523-4681
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- Pfizer Novartis Pharmaceuticals; Novartis National Heart, Lung and Blood Institute [NHLBI]; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) AR053105; AR048919 / US Public Health Service; United States Department of Health & Human Services; United States Public Health Service Novartis Procter & Gamble Pharmaceuticals; Procter & Gamble NHLBI, National Institutes of Health, U.S. Department of Health and Human Services Merck Co.; Merck & Company GlaxoSmithKline R01AR048919 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) Eli Lilly Co.; Eli Lilly Proctor & Gamble Pharmaceutical Co. Amgen Alliance for Better Bone Health
- Language
- English
- Date published
- 05/01/2012
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363620402771
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