Calciotropic hormones and the risk of hip and nonspine fractures in older adults

The health ABC study

Kamil E. Barbour, Denise K. Houston, Steven R. Cummings, Robert Boudreau, Tanushree Prasad, Yahtyng Sheu, Douglas C. Bauer, Janet A. Tooze, Stephen B. Kritchevsky, Frances Tylavsky, Tamara B. Harris, Jane A. Cauley

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

The effects of vitamin D and parathyroid hormone (PTH) levels on incident fracture remain uncertain. To test the hypothesis that increasing serum 25-hydroxyvitamin D [25(OH)D] and decreasing PTH levels are associated with decreased risk of hip and any nonspine fracture, we conducted a prospective cohort study among 2614 community-dwelling white and black participants, aged ≥70 years, from the Health, Aging and Body Composition (Health ABC) Study. Serum and plasma samples were drawn at year 2, which formed the baseline for this analysis. Serum 25(OH)D and intact PTH (1-84) were measured using radioimmunoassay with DiaSorin reagents and EDTA plasma with a two-site immunoradiometric assay kit, respectively. Incident fractures (hip and any nonspine) were assessed after year 2, every 6 months, by self-report and validated by radiology reports. The median (interquartile range) follow-up times for hip and any nonspine fractures were 6.4 (6.1-6.5) and 6.4 (5.5-6.5) years, respectively. Cox proportional hazards regression was used to estimate the hazard ratios (HR) with 95% confidence intervals (CI) for fracture. There were 84 hip and 247 nonspine fractures that occurred over the follow-up period. The multivariable adjusted HRs (95% CIs) of hip fracture for participants in the lowest (≤17.78 ng/mL), second (17.79 to 24.36 ng/mL), and third quartiles (24.37 to 31.94 ng/mL) of 25(OH)D were 1.92 (0.97 to 3.83), 0.75 (0.32 to 1.72) and 1.86 (1.00 to 3.45), respectively, compared with participants in the highest 25(OH)D quartile (>31.94 ng/mL) (p trend=0.217). Additional adjustment for IL-6 (p=0.107), PTH (p=0.124), and hip areal bone mineral density (p=0.137) attenuated HRs of hip fracture in the lowest quartile by 16.3%, 17.4%, and 26.1%, respectively. There was no evidence of an association between 25(OH)D and any nonspine fractures, or between PTH and hip or any nonspine fractures. We found limited evidence to support an association between calciotropic hormones and hip and nonspine fractures in older men and women.

Original languageEnglish (US)
Pages (from-to)1177-1185
Number of pages9
JournalJournal of Bone and Mineral Research
Volume27
Issue number5
DOIs
StatePublished - May 1 2012

Fingerprint

Hip Fractures
Parathyroid Hormone
Hormones
Hip
Health
Serum
Pelvic Bones
Independent Living
Immunoradiometric Assay
Body Composition
Radiology
Vitamin D
Edetic Acid
Bone Density
Self Report
Radioimmunoassay
Interleukin-6
Cohort Studies
Prospective Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Barbour, K. E., Houston, D. K., Cummings, S. R., Boudreau, R., Prasad, T., Sheu, Y., ... Cauley, J. A. (2012). Calciotropic hormones and the risk of hip and nonspine fractures in older adults: The health ABC study. Journal of Bone and Mineral Research, 27(5), 1177-1185. https://doi.org/10.1002/jbmr.1545

Calciotropic hormones and the risk of hip and nonspine fractures in older adults : The health ABC study. / Barbour, Kamil E.; Houston, Denise K.; Cummings, Steven R.; Boudreau, Robert; Prasad, Tanushree; Sheu, Yahtyng; Bauer, Douglas C.; Tooze, Janet A.; Kritchevsky, Stephen B.; Tylavsky, Frances; Harris, Tamara B.; Cauley, Jane A.

In: Journal of Bone and Mineral Research, Vol. 27, No. 5, 01.05.2012, p. 1177-1185.

Research output: Contribution to journalArticle

Barbour, KE, Houston, DK, Cummings, SR, Boudreau, R, Prasad, T, Sheu, Y, Bauer, DC, Tooze, JA, Kritchevsky, SB, Tylavsky, F, Harris, TB & Cauley, JA 2012, 'Calciotropic hormones and the risk of hip and nonspine fractures in older adults: The health ABC study', Journal of Bone and Mineral Research, vol. 27, no. 5, pp. 1177-1185. https://doi.org/10.1002/jbmr.1545
Barbour, Kamil E. ; Houston, Denise K. ; Cummings, Steven R. ; Boudreau, Robert ; Prasad, Tanushree ; Sheu, Yahtyng ; Bauer, Douglas C. ; Tooze, Janet A. ; Kritchevsky, Stephen B. ; Tylavsky, Frances ; Harris, Tamara B. ; Cauley, Jane A. / Calciotropic hormones and the risk of hip and nonspine fractures in older adults : The health ABC study. In: Journal of Bone and Mineral Research. 2012 ; Vol. 27, No. 5. pp. 1177-1185.
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abstract = "The effects of vitamin D and parathyroid hormone (PTH) levels on incident fracture remain uncertain. To test the hypothesis that increasing serum 25-hydroxyvitamin D [25(OH)D] and decreasing PTH levels are associated with decreased risk of hip and any nonspine fracture, we conducted a prospective cohort study among 2614 community-dwelling white and black participants, aged ≥70 years, from the Health, Aging and Body Composition (Health ABC) Study. Serum and plasma samples were drawn at year 2, which formed the baseline for this analysis. Serum 25(OH)D and intact PTH (1-84) were measured using radioimmunoassay with DiaSorin reagents and EDTA plasma with a two-site immunoradiometric assay kit, respectively. Incident fractures (hip and any nonspine) were assessed after year 2, every 6 months, by self-report and validated by radiology reports. The median (interquartile range) follow-up times for hip and any nonspine fractures were 6.4 (6.1-6.5) and 6.4 (5.5-6.5) years, respectively. Cox proportional hazards regression was used to estimate the hazard ratios (HR) with 95{\%} confidence intervals (CI) for fracture. There were 84 hip and 247 nonspine fractures that occurred over the follow-up period. The multivariable adjusted HRs (95{\%} CIs) of hip fracture for participants in the lowest (≤17.78 ng/mL), second (17.79 to 24.36 ng/mL), and third quartiles (24.37 to 31.94 ng/mL) of 25(OH)D were 1.92 (0.97 to 3.83), 0.75 (0.32 to 1.72) and 1.86 (1.00 to 3.45), respectively, compared with participants in the highest 25(OH)D quartile (>31.94 ng/mL) (p trend=0.217). Additional adjustment for IL-6 (p=0.107), PTH (p=0.124), and hip areal bone mineral density (p=0.137) attenuated HRs of hip fracture in the lowest quartile by 16.3{\%}, 17.4{\%}, and 26.1{\%}, respectively. There was no evidence of an association between 25(OH)D and any nonspine fractures, or between PTH and hip or any nonspine fractures. We found limited evidence to support an association between calciotropic hormones and hip and nonspine fractures in older men and women.",
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