High Plasma Sphingosine 1-phosphate Levels Predict Osteoporotic Fractures in Postmenopausal Women: The Center of Excellence for Osteoporosis Research Study.
High Plasma Sphingosine 1-phosphate Levels Predict Osteoporotic Fractures in Postmenopausal Women: The Center of Excellence for Osteoporosis Research Study.
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DOI：
10.11005/jbm.2018.25.2.87
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发表时间：
2018-05
影响因子：
--
通讯作者：
Mousa SA
中科院分区：
文献类型：
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作者：
Ardawi MM;Rouzi AA;Al-Senani NS;Qari MH;Elsamanoudy AZ;Mousa SA
较高的1-磷酸鞘氨醇（S1 P）血浆水平与骨矿物质密度（BMD）降低和椎体骨折风险增加有关。因此，我们假设基线血浆S1 P水平升高的绝经后妇女将来发生骨折（骨关节炎相关骨折[ORF]）的风险更大。这项研究是在2004年招募的707名女性的前瞻性纵向队列中进行的，每年随访一次，平均随访时间为5.2±1.3年。他们是绝经后（年龄≥50岁）。主要结局指标是使用X线片和/或手术报告首次确认ORF事件的时间。发生骨折的女性血浆S1 P水平（µmol/L）（7.23±0.79）明显高于无ORF的女性（5.02±0.51; P<0.001）。高S1 P水平与骨折风险增加密切相关。校正年龄和其他混杂因素后，血浆S1 P水平每增加1个标准差，风险比（HR）为6.12（95%置信区间[CI]，4.92 - 7.66）。S1 P水平最高四分位数的女性骨折风险显著增加（HR，9.89; 95%CI，2.83 - 34.44）。当我们比较1年访视时的血浆S1 P水平时，结果相似。血浆S1 P水平与骨折风险之间的相关性与BMD和其他混杂因素无关。这些结果表明，在基线和1至5年的高血浆S1 P水平是绝经后妇女未来[ORF]的一个强有力的独立风险因素，可能是该人群骨折风险评估的一个有用的生物标志物。
Higher sphingosine 1-phosphate (S1P) plasma levels are associated with decreased bone mineral density (BMD), and increased risk of prevalent vertebral fracture. So, we hypothesized that postmenopausal women with increased baseline plasma S1P levels have a greater risk for future incident fracture (osteoporosis-related fractures [ORFs]). This study was conducted in a prospective longitudinal cohort of 707 women recruited in 2004 and followed up annually for a mean period of 5.2±1.3 years. They were postmenopausal (aged ≥50 years). The primary outcome measure was the time to the first confirmed ORF event using radiographs and/or a surgical report. The plasma S1P levels (µmol/L) were significantly higher in the women with incident fracture (7.23±0.79) than in those without ORFs (5.02±0.51; P<0.001). High S1P levels were strongly associated with increased fracture risk. After adjustment for age and other confounders, the hazard ratio (HR) was 6.12 (95% confidence interval [CI], 4.92−7.66) for each 1-standard deviation increase in plasma S1P levels. The women in the highest quartile of S1P levels had a significant increase in fracture risk (HR, 9.89; 95% CI, 2.83−34.44). Results were similar when we compared plasma S1P levels at the 1-year visit. The associations between plasma S1P levels and fracture risk were independent of BMD and other confounders. These findings demonstrate that high plasma S1P level at baseline and at years 1 to 5 is a strong and independent risk factor for future [ORFs] among postmenopausal women and could be a useful biomarker for fracture risk assessment in this population.