title: Higher circulating hsCRP levels are associated with lower bone mineral density in healthy pre- and postmenopausal women: evidence for a link between systemic inflammation and osteoporosis.
abstract: Factors involved in inflammation are linked with those critical for bone remodeling. We examined the association between serum high sensitivity C-reactive protein (hsCRP) levels and bone mineral density (BMD) in healthy women. Serum concentrations of hsCRP and total alkaline phosphatase (ALP) were measured in premenopausal ( n =3,662) and postmenopausal ( n =1,031) women aged 30 years or older. BMD was measured at the femoral neck and lumbar spine using dual energy X-ray absorptiometry. According to the WHO definition, osteopenia was diagnosed at -2.5< T -score < -1.0 SD, and osteoporosis was diagnosed at T -score < or = -2.5 SD at any sites. Compared with normal subjects, log-transformed serum hsCRP levels were higher in osteopenic and osteoporotic subjects (all, P < 0.001) with linearity ( P for trend <0.001), after adjustment for age, BMI and menopausal status. Menopausal status did not have a significant interaction on the association ( P =0.457). In both premenopausal and postmenopausal women, serum total ALP levels were higher in the subjects with higher hsCRP quintiles than those with the lowest quintile (all, P for trend < 0.001). Multivariate-adjusted odds ratio (OR) for osteoporosis and osteopenia were 1.35 (95% CI, 1.08 to 1.68) in the highest hsCRP quintile of premenopausal women, and OR for osteoporosis was 1.54 (95% CI, 1.10 to 2.53) in the highest hsCRP quintile of postmenopausal women. These findings suggest that subclinical systemic inflammation may be associated with bone turnover rate and bone mass in healthy women.
authors.affiliation: Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-Dong Songpa-Gu, 138-736, Seoul, Republic of Korea.
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Koh
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Khang
authors.forename: Chang-Hee
authors.initials: CH
authors.lastname: Jung
authors.forename: Sungjin
authors.initials: S
authors.lastname: Bae
authors.forename: Duk Jae
authors.initials: DJ
authors.lastname: Kim
authors.forename: Yun-Ey
authors.initials: YE
authors.lastname: Chung
authors.forename: Ghi Su
authors.initials: GS
authors.lastname: Kim
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D017698:Postmenopause / Q000097:blood / Q000502:physiology; D017697:Premenopause / Q000097:blood / Q000502:physiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D000469:Alkaline Phosphatase