Poor Trabecular Microarchitecture at the Distal Radius in Older Men with Increased Concentration of High-Sensitivity C-Reactive Protein—The Strambo Study

Abstract

Low-grade inflammation, assessed by serum high-sensitivity C-reactive protein (hsCRP) concentration, is associated with higher fracture risk irrespective of areal bone mineral density (aBMD). We assessed the association of hsCRP with bone microarchitecture (measured by high-resolution pQCT) at the distal radius and tibia in 1,149 men, aged 19-87 years. hsCRP concentration increased with age until the age of 72, then remained stable. aBMD was not correlated with hsCRP level. After adjustment for confounders, bone microarchitecture was not associated with hsCRP level in men aged <72. After the age of 72, hsCRP >5 mg/L was associated with lower trabecular density, lower trabecular number, higher trabecular spacing, and more heterogeneous trabecular distribution (p < 0.05-0.005) at the distal radius versus hsCRP ≤ 5 mg/L. Similar differences were found for the fourth hsCRP quartile (>3.69 mg/L) versus the three lower quartiles combined. Cortical parameters of distal radius and microarchitectural parameters of distal tibia did not vary according to hsCRP concentration in men aged ≥ 72. Fracture prevalence increased with increasing hsCRP level. After adjustment for confounders (including aBMD), odds for fracture were higher in men with hsCRP >5 mg/L compared to hsCRP <1 mg/L (OR = 2.22, 95 % CI 1.29-3.82) and did not change after additional adjustment for microarchitectural parameters. The association between hsCRP level and bone microarchitecture was observed only for trabecular parameters at the radius in men aged ≥72. Impaired bone microarchitecture does not seem to explain the association between elevated CRP level and higher risk of fracture.

C-reactive protein, bone loss, fracture, and mortality in elderly women: a longitudinal study in the OPRA cohort

“…Hip fracture risk was not associated with CRP. Our results differ from previous studies reporting that the risk of fracture increases with higher CRP [20,22,23,31]. Schett et al found a higher relative risk for non--traumatic fractures in the highest vs. the lowest tertile of CRP in a middle aged population [24] and similarly, Eriksson et al…”

“…Previous studies have demonstrated an inverse association between CRP and femoral neck composite strength index [22] while others have reported that CRP is associated with changes in trabecular bone in older men [31]. In neither study was BMD associated with CRP.…”

“…In terms of fracture risk, several studies have also reported no association between elevated CRP and low BMD, despite a higher fracture risk [21,22,24,31].…”

Serum myostatin levels are negatively associated with abdominal aortic calcification in older men: the STRAMBO study

“…Fibroblast growth factor 23 (FGF23) was measured by ELISA (Biomedica, Vienna, Austria) as described previously (26). High-sensitivity C-reactive protein (hsCRP) was measured by an immunoturbidimetric assay (Cobas; Roche Diagnostics) (27). Testosterone was measured with a RIA after diethylether extraction; sex hormonebinding globulin was measured using an IRMA ( 125 ISBP Coatria; Bio-Mérieux, Marcy l'Etoile, France) (28).…”

High-sensitivity C-reactive protein is an independent risk factor for non-vertebral fractures in women and men: The Tromsø Study

“…However, the association between levels of CRP and bone mineral density (BMD) is conflicting. (16,21,24,25) A recent study showed that CRP was not associated with femoral neck and lumbar spine BMD, but inversely associated with bone strength index, which partially explained the increased fracture risk that was associated with inflammation. (17) We hypothesized that higher levels of CRP increase the risk of nonvertebral fracture in Tromsø, a population with a high incidence of fracture, and we aimed to test whether CRP is an independent risk factor for non-vertebral fractures, and whether CRP is associated with BMD, in both genders.…”