Inflammatory markers and incident fracture risk in older men and women: The health aging and body composition study
Inflammatory markers and incident fracture risk in older men and women: The health aging and body composition study
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DOI：
10.1359/jbmr.070409
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发表时间：
2007-07-01
影响因子：
6.2
通讯作者：
Newman, Anne B.
中科院分区：
文献类型：
--
作者：
Cauley, Jane A.;Danielson, Michelle E.;Newman, Anne B.
衰老的炎症假说认为，衰老是损伤的积累，部分原因是炎症过程的慢性激活。我们在2985名参加健康ABC研究的男性和女性中测试了这一假设与骨折的关系。结果表明，炎症标志物数量最多的受试者骨折风险最高。细胞因子在骨微环境中调控骨重塑发挥重要作用，但其与骨折的关系尚不确定。材料和方法：研究人群包括2985名功能良好的白人和黑人女性和男性（黑人42%，女性51%），年龄在70-79岁，参加了健康老龄化和身体成分研究。使用标准化测定法测定冷冻血清中的炎症标志物。我们测量了白细胞介素（IL-6）、TNF α、c反应蛋白（CRP）和可溶性受体（il - 2sr、il - 6sr、TNF sRIand TNF sR2）。在一个亚群中测量细胞因子可溶性受体（n = 1430）。用DXA测量髋部总骨密度。在95%完全随访的5.8 +/- 1.6年期间，268名受试者确认发生偶发性骨折。使用比例风险模型比较炎症标志物最高（四分位数4）和较低（四分位数1、2和3）受试者的骨折风险。结果和结论：骨折的受试者更可能是白人和女性。在随后经历意外骨折的受试者中，炎症的基线指标较高。在多变量模型中，炎症标志物最高（四分位数4）的受试者与炎症标志物较低（四分位数1、2和3）的受试者相比，CRP的相对骨折风险（95% Cls）为1.34 (0.99,1.82)；IL-6为1.28 (0.95 ~ 1.74)；TNF - α为1.28 (0.97-1.70)；IL-2 sR为1.52 (1.04-2.21)；IL-6 sR为1.33 (0.90-1.96)；TNF - sR1为1.73 (1.18-2.55)，TNF - sR2为1.48（1.01-2.20）。在7个炎症标志物中有3个或更多高炎症标志物的受试者中，骨折的相对风险为2.65（1.44-4.89）。（p趋势= 0.001）。我们得出结论，炎症标志物升高是骨折的预后因素，将衰老的炎症假设扩展到骨质疏松性骨折。
The inflammation of aging hypothesis purports that aging is the accumulation of damage, which results, in part, from chronic activation of inflammation process. We tested this hypothesis in relationship to fractures in 2985 men and women enrolled in the Health ABC study. Results showed that subjects with the greatest number of inflammatory markers have the highest risk of fracture.Introduction: Cytokines play major roles in regulating bone remodeling in the bone microenvironment, but their relationship to fractures is uncertain.Materials and Methods: The study population includes 2985 well-functioning white and black women and men (42%, black; 51%, women) 70-79 yr of age enrolled in the Health Aging and Body Composition Study. Inflammatory markers were measured in frozen serum using standardized assays. We measured interleukin (IL-6), TNF alpha, C-reactive protein (CRP), and soluble receptors (IL-2 sR, IL-6 sR, TNF sRIand TNF sR2).Cytokine-soluble receptors were measured in a subset (n = 1430). Total hip BMD was measured by DXA. During 5.8 +/- 1.6 yr of 95% complete follow-up, incident fractures were confirmed in 268 subjects. The risk of fracture was compared among subjects with the highest inflammatory markers (quartile 4) versus lower levels (quartiles 1, 2, and 3) using proportional hazard models.Results and Conclusions: Subjects who fractured were more likely to be white and female. Baseline markers of inflammation were higher among subjects who subsequently experienced an incident fracture. In multivariate models, the relative risk of fracture (95% Cls) for subjects with the highest inflammatory markers (quartile 4) compared with those with lower inflammatory markers (quartiles 1, 2, and 3) was 1.34 (0.99, 1.82) for CRP; 1.28 (0.95-1.74) for IL-6; 1.28 (0.97-1.70) for TNF alpha; 1.52 (1.04-2.21) for IL-2 sR; 1.33 (0.90-1.96) for IL-6 sR; 1.73 (1.18-2.55) for TNF sR1 and 1.48 (1.01-2.20) for TNF sR2. In subjects with three or more (out of seven) high inflammatory markers, the relative risk of fracture was 2.65 (1.44-4.89) in comparison with subjects with no elevated markers. (p trend = 0.001). We conclude that elevated inflammatory markers are prognostic for fractures, extending the inflammation hypothesis of aging to osteoporotic fractures.