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Oxidative stress predicted future hip fracture for postmenopausal women
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Oxidative stress determined through blood samples independently predicted future hip fractures in postmenopausal women, according to research published in the Journal of Bone and Mineral Research.
A prospective study of women in the Nurses’ Health Study is the first to demonstrate the association, which could present a method to assess fracture risk beyond age and osteoporosis, according to researchers.
Shuman Yang, a postdoctoral fellow in the Department of Environmental Health at the University of Cincinnati, along with professor Tianying Wu, MD, PhD, and colleagues from other institutions, looked at 996 women aged ≥60 years at baseline blood collection.
To assess the physiological stress on the body, caused by the cumulative damage of free radicals that occur naturally but are also influenced by the environment, the investigators measured fluorescent oxidation products (FlOP) in blood plasma; FlOP assay offers 10 to 100 times more sensitivity than malondialdehyde.
Plasma FlOPs — generated from many different pathways including lipid, protein and DNA, and reflecting global oxidation burden — were measured at three emission wavelengths: 360/420 nm, or FlOP_360; 320/420 nm, or FlOP_320; and 400/475 nm, or FlOP_400).
The researchers used Cox proportional hazards regression to gauge associations between FlOPs and hip fracture risk; adjustments were made for multiple risk factors including age, history of osteoporosis or hypertension, prior fracture and smoking status.
During follow-up (maximum 23 years), 44 hip fractures (4.4%) were identified. Hip fracture risk was lower in FlOP_320 tertile 2 (HR=2.11; 95% CI, 0.88–5.10) and tertile 3 (HR=2.67; 1.14–6.27) compared with tertile 1. Higher plasma FlOP_320 was an independent risk factor for hip fracture, with risk increasing linearly with plasma levels (P for trend=.021).
No significant associations were observed between hip fracture risk and FlOP_360 (tertile 3 vs. tertile 1: HR=0.70; 95% CI, 0.32–1.54) or FlOP_400 (HR=0.88; 0.40–1.96).
“Since this is the first prospective study examining the relationship of oxidative stress with fracture risk, our findings warrant further investigation and validation,” the researchers wrote. “In addition, the underlying mechanisms for FlOP_320 as a risk factor for hip fracture merit additional studies.”
Disclosures: The study was partly funded by an American Heart Association grant award and research grants from the NIH, Bethesda, MD.
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