C-reactive protein predicts incident fracture in community-dwelling elderly Japanese women: the Muramatsu study
C-reactive protein predicts incident fracture in community-dwelling elderly Japanese women: the Muramatsu study
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DOI：
10.1007/s00198-010-1425-9
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发表时间：
2011-07-01
影响因子：
4
通讯作者：
Tsuchiya, Y.
中科院分区：
文献类型：
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作者：
Nakamura, K.;Saito, T.;Tsuchiya, Y.
在对 751 名居住在社区的日本老年女性进行的一项为期 6 年的队列研究中，我们发现 C 反应蛋白 (CRP) 是亚洲老年女性骨质疏松性骨折的重要预测因子，她们的 CRP 水平显着低于白人。应该进一步研究解释这种关联的机制。虽然 CRP（一种全身炎症标志物）被认为与骨质疏松症相关，但支持这一说法的证据有限。我们旨在评估老年女性 CRP 水平与骨质疏松性骨折发生率之间的关联。我们进行了一项随访期为 6 年的队列研究。该研究纳入了 751 名 69 岁或以上的日本女性。我们测量了血清高敏 CRP (hs-CRP) 水平作为主要预测因子。协变量包括年龄、体重指数、前臂骨矿物质密度、钙摄入量、血清 25-羟基维生素 D、姿势摇摆、骨质疏松症药物和体力活动。主要结局是发生肢体和椎骨骨折。采用Cox比例风险模型计算骨折风险比（HR）。研究参与者的hs-CRP中位数在最低三分位中为0.16 mg/L，在中等三分位中为0.36 mg/L，在最高三分位中为1.14 mg/L。这些女性的 hs-CRP 值明显低于白人女性。在 4,250 人年中，50 名受试者发生了肢体或椎骨骨折。低 CRP 水平与四肢或椎骨骨折的低发生率相关（趋势 P = 0.035）。与最低四分位相比，hs-CRP 水平的中四分位和最高四分位的骨折调整 HR 分别为 2.22 (95% CI, 1.02-4.84) 和 2.40 (95% CI, 1.10-5.24)。 对于 CRP 水平显着低于白种人的老年亚洲女性来说，CRP 是骨质疏松性骨折的重要预测因子。应进一步研究解释这种关联的机制。
In a 6-year cohort study of 751 community-dwelling elderly Japanese women, we found that C-reactive protein (CRP) is a significant predictor of osteoporotic fracture in elderly Asian women, who have significantly lower CRP levels than Caucasians. Mechanisms explaining such an association should be further studied.While CRP, a systemic inflammation marker, is thought to be associated with osteoporosis, evidence supporting this claim has been limited. We aimed to assess the association between CRP levels and incident osteoporotic fracture in elderly women.We conducted a cohort study with a follow-up period of 6 years. The study included 751 Japanese women aged 69 years or older. We measured serum high-sensitivity CRP (hs-CRP) levels as a major predictor. Covariates included age, body mass index, forearm bone mineral density, calcium intake, serum 25-hydroxyvitamin D, postural sway, osteoporosis medication, and physical activity. The primary outcome was incident limb and vertebral fractures. The Cox proportional hazards model was used to calculate the hazard ratio (HR) of fracture.Median hs-CRP values in study participants were 0.16 mg/L in the lowest tertile, 0.36 mg/L in the medium tertile, and 1.14 mg/L in the highest tertile. The hs-CRP values in these women were substantially lower than in their Caucasian counterparts. Limb or vertebral fractures occurred in 50 subjects during 4,250 person-years. Low CRP levels were associated with low incidence of limb or vertebral fractures (P for trend = 0.035). The adjusted HRs of fracture for the medium and highest quartiles of hs-CRP levels, compared to the lowest quartile, were 2.22 (95% CI, 1.02-4.84) and 2.40 (95% CI, 1.10-5.24), respectively.CRP is a significant predictor of osteoporotic fracture in elderly Asian women who have substantially lower CRP levels than Caucasians. Mechanisms explaining such an association should be further studied.