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Adipokines and the risk of fracture in older adults
Author(s) -
Barbour Kamil E,
Zmuda Joseph M,
Boudreau Robert,
Strotmeyer Elsa S,
Horwitz Mara J,
Evans Rhobert W,
Kanaya Alka M,
Harris Tamara B,
Bauer Douglas C,
Cauley Jane A
Publication year - 2011
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.361
Subject(s) - adiponectin , medicine , hazard ratio , leptin , adipokine , proportional hazards model , body mass index , bone mineral , prospective cohort study , confidence interval , endocrinology , cohort study , cohort , obesity , osteoporosis , insulin resistance
Adiponectin and leptin are adipokines that influence bone metabolism in vitro and in animal models. However, less is known about the longitudinal association of leptin and adiponectin with fracture. We tested the hypothesis that low leptin and high adiponectin levels are each individually associated with fracture risk in a prospective cohort study in Memphis and Pittsburgh among 3075 women and men aged 70 to 79 years from the Health Aging and Body Composition (Health ABC) study. There were 406 incident fractures (334 nonvertebral and 72 vertebral) over a mean of 6.5 ± 1.9 years. Cox regression was used to estimate the hazard ratios for fracture. Sex modified the association between adiponectin and fracture ( p = .025 for interaction). Men with the highest adiponectin level (tertile 3) had a 94% higher risk of fracture [hazard ratio (HR) = 1.94; 95% confidence interval (CI) 1.20–3.16] compared with the lowest tertile (tertile 1; p = .007 for trend) after adjusting age, race, body mass index (BMI), education, diabetes, weight change, and hip bone mineral density (BMD). Among women, after adjusting for age and race, this association was no longer significant ( p = .369 for trend). Leptin did not predict fracture risk in women ( p = .544 for trend) or men ( p = .118 for trend) in the multivariate models. Our results suggest that adiponectin, but not leptin, may be a novel risk factor for increased fracture risk independent of body composition and BMD and that these relationships may be influenced by sex. More research is needed to understand the physiologic basis underlying these sex differences. © 2011 American Society for Bone and Mineral Research.