Inflammatory markers and the risk of hip fracture: the Women's Health Initiative.
Inflammatory markers and the risk of hip fracture: the Women's Health Initiative.
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DOI：
10.1002/jbmr.1559
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发表时间：
2012-05
期刊：
影响因子：
--
通讯作者：
Cauley JA
中科院分区：
文献类型：
--
作者：
Barbour KE;Boudreau R;Danielson ME;Youk AO;Wactawski-Wende J;Greep NC;LaCroix AZ;Jackson RD;Wallace RB;Bauer DC;Allison MA;Cauley JA
细胞因子在体外和动物模型中的骨重塑中发挥着重要作用，有证据支持炎症标志物参与骨质疏松症的发病机制。然而，人们对炎症标志物与髋部骨折的纵向关联知之甚少。我们测试了高促炎细胞因子受体水平是否与老年女性髋部骨折风险增加相关。我们采用了女性健康倡议观察研究 (WHI-OS) 的巢式病例对照研究设计，并选择了 400 例经医生判定发生髋部骨折的病例和 400 例年龄、种族和抽血日期相匹配的对照。参与者是从 39,795 名既往没有髋部骨折且未使用雌激素或其他骨活性疗法的绝经后女性中选出的。髋部骨折事件（中位随访时间 7.1 年）通过 X 光片检查进行验证，并由盲法中央裁判员确认。排除病理原因引起的髋部骨折。在多变量模型中，与炎症标志物水平较低（四分位数 1、2 和 3）的受试者相比，炎症标志物水平最高的受试者（四分位数 4）发生髋部骨折的风险，IL-6 SR 为 1.43（95% CI，0.98 至 2.07），TNF SR1 为 1.41（95% CI，0.97 至 2.05），TNF SR1 为 1.57（95%）。 TNF SR2 的 CI，1.09 至 2.25）。与具有 0 或 1 个升高标志物的受试者相比，所有三个标志物均位于最高四分位数的受试者中，骨折风险比为 2.27（95% CI 为 1.04 至 4.93）（p 趋势 = 0.042）。所有 3 种细胞因子可溶性受体的炎症标志物水平升高与老年女性髋部骨折的风险增加相关。未来的临床试验应该测试降低炎症标志物水平的干预措施是否可以减少髋部骨折。
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 pro-inflammatory 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 age, race, and date of blood draw matched controls. 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% CI, 0.98 to 2.07) for IL-6 SR and 1.41 (95% CI, 0.97 to 2.05) for TNF SR1 and 1.57 (95% CI, 1.09 to 2.25) for TNF SR2. In subjects with all three markers in the highest quartile, the risk ratio of fracture was 2.27 (95% CI to 1.04 to 4.93) in comparison with subjects with 0 or 1 elevated marker(s) (p trend = 0.042). Elevated levels of inflammatory markers for all 3 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.
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DOI：
10.1053/j.ajkd.2008.10.044
发表时间：
2009-04
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Bash LD;Erlinger TP;Coresh J;Marsh-Manzi J;Folsom AR;Astor BC
通讯作者：
Astor BC
影响因子：
6.2
作者：
Abrahamsen, B;Bonnevie-Nielsen, V;Beck-Nielsen, H
通讯作者：
Beck-Nielsen, H
影响因子：
5.9
作者：
Harris, TB;Ferrucci, L;Wallace, R
通讯作者：
Wallace, R
影响因子：
5.6
作者：
Anderson, GL;Manson, J;Prentice, RL
通讯作者：
Prentice, RL
影响因子：
56.9
作者：
JILKA, RL;HANGOC, G;MANOLAGAS, SC
通讯作者：
MANOLAGAS, SC