Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults

The Cardiovascular Health Study

Howard A. Fink, Petra Bůžková, Pranav S. Garimella, Kenneth J. Mukamal, Jane A. Cauley, Jorge Kizer, Joshua I. Barzilay, Diana I. Jalal, Joachim H. Ix

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95% CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95% CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm<sup>2</sup>; 95% CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm<sup>2</sup>; 95% CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm<sup>2</sup>; 95% CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture.

Original languageEnglish (US)
Pages (from-to)1394-1402
Number of pages9
JournalJournal of Bone and Mineral Research
Volume30
Issue number8
DOIs
StatePublished - Aug 1 2015

Fingerprint

alpha-2-HS-Glycoprotein
Independent Living
International Classification of Diseases
Health
Bone Density
Hip Fractures
Hip
Confounding Factors (Epidemiology)
Femur Neck
Humerus
Medicare
Pelvis
Proportional Hazards Models
Forearm
Blood Proteins
Spine
Cross-Sectional Studies
Calcium
Bone and Bones
Incidence

Keywords

  • ALPHA-2-HS-GLYCOPROTEIN
  • FETUINS
  • FRACTURES
  • GERIATRICS
  • HIP FRACTURES
  • RISK FACTORS

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults : The Cardiovascular Health Study. / Fink, Howard A.; Bůžková, Petra; Garimella, Pranav S.; Mukamal, Kenneth J.; Cauley, Jane A.; Kizer, Jorge; Barzilay, Joshua I.; Jalal, Diana I.; Ix, Joachim H.

In: Journal of Bone and Mineral Research, Vol. 30, No. 8, 01.08.2015, p. 1394-1402.

Research output: Contribution to journalArticle

Fink, HA, Bůžková, P, Garimella, PS, Mukamal, KJ, Cauley, JA, Kizer, J, Barzilay, JI, Jalal, DI & Ix, JH 2015, 'Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults: The Cardiovascular Health Study', Journal of Bone and Mineral Research, vol. 30, no. 8, pp. 1394-1402. https://doi.org/10.1002/jbmr.2475
Fink, Howard A. ; Bůžková, Petra ; Garimella, Pranav S. ; Mukamal, Kenneth J. ; Cauley, Jane A. ; Kizer, Jorge ; Barzilay, Joshua I. ; Jalal, Diana I. ; Ix, Joachim H. / Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults : The Cardiovascular Health Study. In: Journal of Bone and Mineral Research. 2015 ; Vol. 30, No. 8. pp. 1394-1402.
@article{1a609cdcca04461d9d719d4f306a42ab,
title = "Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults: The Cardiovascular Health Study",
abstract = "Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95{\%} CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95{\%} CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm2; 95{\%} CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm2; 95{\%} CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm2; 95{\%} CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture.",
keywords = "ALPHA-2-HS-GLYCOPROTEIN, FETUINS, FRACTURES, GERIATRICS, HIP FRACTURES, RISK FACTORS",
author = "Fink, {Howard A.} and Petra Bůžkov{\'a} and Garimella, {Pranav S.} and Mukamal, {Kenneth J.} and Cauley, {Jane A.} and Jorge Kizer and Barzilay, {Joshua I.} and Jalal, {Diana I.} and Ix, {Joachim H.}",
year = "2015",
month = "8",
day = "1",
doi = "10.1002/jbmr.2475",
language = "English (US)",
volume = "30",
pages = "1394--1402",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults

T2 - The Cardiovascular Health Study

AU - Fink, Howard A.

AU - Bůžková, Petra

AU - Garimella, Pranav S.

AU - Mukamal, Kenneth J.

AU - Cauley, Jane A.

AU - Kizer, Jorge

AU - Barzilay, Joshua I.

AU - Jalal, Diana I.

AU - Ix, Joachim H.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95% CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95% CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm2; 95% CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm2; 95% CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm2; 95% CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture.

AB - Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95% CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95% CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm2; 95% CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm2; 95% CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm2; 95% CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture.

KW - ALPHA-2-HS-GLYCOPROTEIN

KW - FETUINS

KW - FRACTURES

KW - GERIATRICS

KW - HIP FRACTURES

KW - RISK FACTORS

UR - http://www.scopus.com/inward/record.url?scp=84937164075&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937164075&partnerID=8YFLogxK

U2 - 10.1002/jbmr.2475

DO - 10.1002/jbmr.2475

M3 - Article

VL - 30

SP - 1394

EP - 1402

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 8

ER -