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 R. Kizer, Joshua I. Barzilay, Diana I. Jalal, Joachim H. Ix

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4 Scopus citations

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.

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

Keywords

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

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

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    Fink, H. A., Bůžková, P., Garimella, P. S., Mukamal, K. J., Cauley, J. A., Kizer, J. R., Barzilay, J. I., Jalal, D. I., & Ix, J. H. (2015). Association of Fetuin-A with Incident Fractures in Community-Dwelling Older Adults: The Cardiovascular Health Study. Journal of Bone and Mineral Research, 30(8), 1394-1402. https://doi.org/10.1002/jbmr.2475