title: Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study.
abstract: BACKGROUND
  Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake.
  
  
  OBJECTIVE
  We aimed to examine associations between fatty acids measured in late life and fish-oil consumption in early life, midlife, and late life with osteoporotic fracture risk.
  
  
  METHODS
  Osteoporotic fractures were determined from medical records over 5-9 y of follow-up in men and women aged 66-96 y. Data were analyzed from 1438 participants including 898 participants who were randomly selected from the Age, Gene/Environment Susceptibility Study, which is an observational study, and 540 participants with incident fracture. Plasma phospholipid fatty acids were assessed by using gas chromatography. Fish-oil consumption was assessed by using validated questionnaires as never (referent), less than daily, or daily. HRs and 95% CIs adjusted for age, education, height, weight, diabetes, physical activity, and medications were estimated by using Cox regression.
  
  
  RESULTS
  In men, the highest tertile of PUFAs, n-3 (ω-3), and eicosapentaenoic acid were associated with decreased fracture risk [HRs (95% CIs): 0.60 (95% CI: 0.41, 0.89), 0.66 (0.45, 0.95), and 0.59 (0.41, 0.86), respectively]. In women, PUFAs tended to be inversely associated with fracture risk (P-trend = 0.06), but tertiles 2 and 3 were not independently associated with risk. Tertile 2 of n-6 and arachidonic acid was associated with fracture risk in women [HRs (95% CIs): 1.43 (1.10, 1.85) and 1.42 (1.09, 1.85), respectively]. Daily fish-oil consumption in late life was associated with lower fracture risk in men (HR: 0.64; 95% CI: 0.45, 0.91). Daily fish-oil consumption in midlife was associated with lower fracture risk in women (HR: 0.75; 95% CI: 0.58, 0.98).
  
  
  CONCLUSIONS
  Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults, particularly in men. Critical time periods for n-3 fatty acid consumption may differ by sex.
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Tamara B
authors: TB
authors: Harris
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Xiaoling
authors: X
authors: Song
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Ilse
authors: I
authors: Reinders
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Thomas F
authors: TF
authors: Lang
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Melissa E
authors: ME
authors: Garcia
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Kristin
authors: K
authors: Siggeirsdottir
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Sigurdur
authors: S
authors: Sigurdsson
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Vilmundur
authors: V
authors: Gudnason
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Gudny
authors: G
authors: Eiriksdottir
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Gunnar
authors: G
authors: Sigurdsson
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Laufey
authors: L
authors: Steingrimsdottir
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Thor
authors: T
authors: Aspelund
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Ingeborg A
authors: IA
authors: Brouwer
authors: From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
authors: Rachel A
authors: RA
authors: Murphy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016718:Arachidonic Acid / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000097:blood* / Q000517:prevention & control; D010743:Phospholipids / Q000097:blood*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils; D010743:Phospholipids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid
keywords: aging; bone health; fatty acids; fish oil; omega-3; osteoporotic fracture