C-reactive protein, bone strength, and nine-year fracture risk: data from the Study of Women's Health Across the Nation (SWAN).

摘要: Higher levels of C-reactive protein (CRP), an inflammatory marker, are associated with increased fracture risk, although previous studies on CRP and bone mineral density (BMD) have yielded conflicting results. We aimed to test the hypotheses that composite indices femoral neck strength relative load, which inversely would also be CRP, explain part association between risk. analyzed data from a multisite, multiethnic prospective cohort 1872 community-dwelling women, premenopausal or early perimenopausal at baseline. Femoral in three failure modes were calculated using dual-energy X-ray absorptiometry (DXA)-derived width (FNW), axis length (FNAL), BMD body size baseline, as BMD*FNW/weight for compression strength, BMD*(FNW)2/(FNAL*weight) bending BMD*FNW*FNAL/(height*weight) impact strength. Incident nondigital, noncraniofacial fractures ascertained annually over median follow-up 9 years. In analyses adjusted age, race/ethnicity, diabetes, menopause transition stage, mass index, smoking, alcohol use, physical activity, medications, prior fracture, study site, was each index (0.035–0.041 SD decrement per doubling all p < 0.001), but not lumbar spine BMD. During follow-up, 194 women (10.4%) had fractures. Cox proportional hazards analyses, hazard linearly loge(CRP), only levels ≥ 3 mg/L. Addition model did attenuate CRP-fracture association. However, addition any attenuated made it statistically nonsignificant. conclude risk increases increasing above threshold 3 mg/L. Unlike BMD, related levels, partially inflammation.