title: Waning predictive value of serum adiponectin for fracture risk in elderly men: MrOS Sweden.
abstract: Serum adiponectin is a risk factor for fracture. The predictive value attenuates with time in elderly men so that its use for the risk assessment in the long term is questionable. The study underlines the importance of testing the long-term stability of potential risk factors.
  
  
  BACKGROUND
  High serum adiponectin is associated with an increased risk of fracture in elderly men. The aim of the present study was to determine the impact of adiponectin on the probability of fracture as a function of time.
  
  
  METHODS
  The probability of osteoporotic fracture was computed in 989 elderly men from the MrOS study in Sweden. Baseline data included clinical risk factors for fracture, femoral neck BMD and serum adiponectin. Men were followed for up to 7.4 years with a mean follow up of 5.3 years (range 0.0-7.4 years). Poisson regression was used to model the hazard function for osteoporotic fracture and death to determine the 10 year probability of fracture.
  
  
  RESULTS
  During follow up, 124 men sustained one or more osteoporotic fracture. There was a significant interaction between adiponectin and time since baseline (p = 0.026) such that the longer time since baseline, the lower the gradient of fracture risk. When using this interaction in the calculation of 10-year probability of fracture, the probabilities of osteoporotic fracture varied little over the range of adiponectin values.
  
  
  CONCLUSIONS
  Serum adiponectin is a risk factor for fracture. Nevertheless, the predictive value attenuates with time so that its use for the risk assessment in the long term is questionable. This study underlines the importance of testing the long-term stability of potential risk factors that might be used in fracture risk assessment.
authors.affiliation: Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, helena.johansson@mbox319.swipnet.se.
authors.forename: H
authors.initials: H
authors.lastname: Johansson
authors.forename: A
authors.initials: A
authors.lastname: Odén
authors.forename: M K
authors.initials: MK
authors.lastname: Karlsson
authors.forename: E
authors.initials: E
authors.lastname: McCloskey
authors.forename: J A
authors.initials: JA
authors.lastname: Kanis
authors.forename: C
authors.initials: C
authors.lastname: Ohlsson
authors.forename: D
authors.initials: D
authors.lastname: Mellström
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology; D005272:Femur Neck / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers