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High sensitive CRP is an independent risk factor for all fractures and vertebral fractures in elderly men The MrOS Sweden study


High sensitive CRP is an independent risk factor for all fractures and vertebral fractures in elderly men The MrOS Sweden study







DOI: 10.1002/jbmr.2037

Epidemiological studies have shown low grade inflammation measured by high sensitivity C-reactive protein (hs-CRP) to be associated with fracture risk in women. However, it is still unclear whether hs-CRP is associated with fracture risk also in men. We therefore measured serum levels of hs-CRP in 2910 men, mean age 75 years, included in the prospective population-based MrOS Sweden cohort. Study participants were divided into tertile groups based on hs-CRP level. Fractures occurring after the baseline visit were validated (average follow-up 5.4 years). The incidence for having at least one fracture after baseline was 23.9/1000 person-years.In cox proportional hazard regression analyses adjusted for age, hs-CRP was related to fracture risk. The HR of fracture for the highest tertile of hs-CRP, compared with the lowest and the medium tertiles combined, was 1.48 (95% CI 1.20 1.82). Multivariate adjustment for other risk factors for fractures had no major effect on the associations between hs-CRP and fracture. were essentially unchanged after exclusion of subjects with hs-CRP levels greater than 7,5 mg/L, as well as after exclusion of subjects with a first fracture within three years of follow-up, supporting that the associations between hs-CRP and fracture risk were not merely a reflection of a poor health status at the time of serum sampling. Femoral neck BMD was not associated with hs-CRP, and the predictive role of hs-CRP for fracture risk was essentially unchanged when femoral neck BMD was added to the model (HR 1.37, 95% CI 1.09 1.72). Exploratory sub-analyses of fracture type demonstrated that hs-CRP was clearly associated with clinical vertebral fractures (HR 1.61, 95% CI 1.12 2.29).We demonstrate, using a large prospective population-based study, that elderly men with high hs-CRP have increased risk of fractures, and that these fractures are mainly vertebral. The association between hs-CRP and fractures was independent of BMD.

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