JBMR
ORIGINAL ARTICLE
Inflammatory Markers and Risk of Hip Fracture in Older White Women: The Study of Osteoporotic Fractures Kamil E Barbour,1 Li‐Yung Lui,2 Kristine E Ensrud,3 Teresa A Hillier,4 Erin S LeBlanc,4 Steven W Ing,5 Marc C Hochberg,6 and Jane A Cauley1 for the Study of Osteoporotic Fractures (SOF) Research Group 1
University of Pittsburgh, Pittsburgh, PA, USA California Pacific Medical Center, San Francisco, CA, USA 3 University of Minnesota and Minneapolis VAHS, Minneapolis, MN, USA 4 Center for Health Research, Kaiser Permanente, Portland, OR, USA 5 The Ohio State University College of Medicine College of Optometry, Columbus, OH, USA 6 University of Maryland School of Medicine, Baltimore, MD, USA 2
ABSTRACT Hip fractures are the most devastating consequence of osteoporosis and impact 1 in 6 white women leading to a two‐ to threefold increased mortality risk in the first year. Despite evidence of inflammatory markers in the pathogenesis of osteoporosis, few studies have examined their effect on hip fracture. To determine if high levels of inflammation increase hip fracture risk and to explore mediation pathways, a case‐cohort design nested in a cohort of 4709 white women from the Study of Osteoporotic Fractures was used. A random sample of 1171 women was selected as the subcohort (mean age 80.1 4.2 years) plus the first 300 women with incident hip fracture. Inflammatory markers interleukin‐6 (IL‐6) and soluble receptors (SR) for IL‐6 (IL‐6 SR) and tumor necrosis factor (TNF SR1 and TNF SR2) were measured, and participants were followed for a median (interquartile range) of 6.3 (3.7, 6.9) years. In multivariable models, the hazard ratio (HR) of hip fracture for women in the highest inflammatory marker level (quartile 4) was 1.64 (95% confidence interval [CI], 1.09–2.48, p trend ¼ 0.03) for IL‐6 and 2.05 (95% CI, 1.35–3.12, p trend
ORIGINAL ARTICLE
Inflammatory Markers and Risk of Hip Fracture in Older White Women: The Study of Osteoporotic Fractures Kamil E Barbour,1 Li‐Yung Lui,2 Kristine E Ensrud,3 Teresa A Hillier,4 Erin S LeBlanc,4 Steven W Ing,5 Marc C Hochberg,6 and Jane A Cauley1 for the Study of Osteoporotic Fractures (SOF) Research Group 1
University of Pittsburgh, Pittsburgh, PA, USA California Pacific Medical Center, San Francisco, CA, USA 3 University of Minnesota and Minneapolis VAHS, Minneapolis, MN, USA 4 Center for Health Research, Kaiser Permanente, Portland, OR, USA 5 The Ohio State University College of Medicine College of Optometry, Columbus, OH, USA 6 University of Maryland School of Medicine, Baltimore, MD, USA 2
ABSTRACT Hip fractures are the most devastating consequence of osteoporosis and impact 1 in 6 white women leading to a two‐ to threefold increased mortality risk in the first year. Despite evidence of inflammatory markers in the pathogenesis of osteoporosis, few studies have examined their effect on hip fracture. To determine if high levels of inflammation increase hip fracture risk and to explore mediation pathways, a case‐cohort design nested in a cohort of 4709 white women from the Study of Osteoporotic Fractures was used. A random sample of 1171 women was selected as the subcohort (mean age 80.1 4.2 years) plus the first 300 women with incident hip fracture. Inflammatory markers interleukin‐6 (IL‐6) and soluble receptors (SR) for IL‐6 (IL‐6 SR) and tumor necrosis factor (TNF SR1 and TNF SR2) were measured, and participants were followed for a median (interquartile range) of 6.3 (3.7, 6.9) years. In multivariable models, the hazard ratio (HR) of hip fracture for women in the highest inflammatory marker level (quartile 4) was 1.64 (95% confidence interval [CI], 1.09–2.48, p trend ¼ 0.03) for IL‐6 and 2.05 (95% CI, 1.35–3.12, p trend
