Serum Sclerostin and Risk of Hip Fracture in Older Caucasian Women
Serum Sclerostin and Risk of Hip Fracture in Older Caucasian Women
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DOI：
10.1210/jc.2011-3419
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发表时间：
2012-06-01
影响因子：
5.8
通讯作者：
Cummings, Steven R.
中科院分区：
文献类型：
--
作者：
Arasu, Aarthi;Cawthon, Peggy M.;Cummings, Steven R.
背景：硬化蛋白是一种由骨细胞分泌的蛋白质，抑制骨形成。个体的遗传突变，减少sclerostin的可用性有很高的bone mass.Objective：本研究的目的是研究假设血清sclerostin水平升高与老年women.Design，设置，和参与者髋部骨折的风险增加：这是一个前瞻性的，以社区为基础的队列研究9704名妇女年龄在65岁或以上。在1989-1990年收集的228例髋部骨折妇女和227例随机抽样妇女的血清中测定硬化素水平，平均随访时间为9.8年。结果：血清硬化素水平与髋部总骨密度（BMD）相关，r = 0.27，P < 0.001。在调整年龄、体重指数、雌激素使用、50岁以后的骨折史和全髋骨密度后，血清硬化素四分位数的妇女髋部骨折的风险增加（趋势检验，P < 0.001），与最低四分位数的妇女相比，第四分位数的妇女髋部骨折的风险显著升高（危险风险3.4，95%置信区间1.7-7.0）。当根据硬化蛋白四分位数和髋部BMD中位数将队列分为8组时，在最高硬化蛋白四分位数中具有较低髋部BMD的女性具有22.3倍的骨密度。（95%置信区间5.8-86.3）与最低sclerostin四分位数中全髋BMD较高的女性相比，骨折风险增加。我们的结论是，较高的血清硬化素水平与老年妇女髋部骨折的风险更大。此外，当高硬化素水平与较低的BMD相结合时，髋部骨折的风险被放大。（临床内分泌代谢杂志97：2027-2032，2012）
Context: Sclerostin, a protein secreted by osteocytes, inhibits bone formation. Individuals with genetic mutations that decrease the availability of sclerostin have very high bone mass.Objective: The aim of this study was to examine the hypothesis that elevated serum sclerostin levels are associated with increased risk of hip fracture in older women.Design, Setting, and Participants: This was a case-cohort study of a prospective, community-based cohort of 9704 women aged 65 yr or older. Sclerostin levels were measured in serum collected in 1989-1990 in 228 women with incident hip fractures and 227 women in a randomly selected sample; average follow-up time was 9.8 yr.Results: Serum sclerostin levels were correlated with total hip bone mineral density (BMD; r = 0.27, P < 0.001). The risk of hip fracture increased across quartiles of serum sclerostin (test for trend, P < 0.001) and was significantly elevated among those in the fourth quartile (hazard risk 3.4, 95% confidence interval 1.7-7.0) compared with women in the lowest quartile, after adjusting for age, body mass index, estrogen use, history of fracture since age 50 yr, and total hip BMD. When dividing the cohort into eight groups by sclerostin quartile and median hip BMD, women with lower total hip BMD in the highest sclerostin quartile had a 22.3-fold (95% confidence interval 5.8-86.3) increased risk of fracture compared with women with higher total hip BMD in the lowest sclerostin quartile.Conclusions: We conclude that higher serum sclerostin levels are associated with a greater risk of hip fractures in older women. In addition, the risk of hip fracture is amplified when high sclerostin levels are combined with lower BMD. (J Clin Endocrinol Metab 97: 2027-2032, 2012)