title: Low grade inflammation is associated with lower velocity of sound and broadband ultrasound attenuation in older men, but not with bone loss or fracture risk in a longitudinal aging study.
abstract: OBJECTIVE
  Elevated systemic levels of pro-inflammatory cytokines involved in the pathogenesis of osteoporosis. Our objective was to investigate whether low grade systemic inflammation was associated with bone markers, bone quality, bone mass and fracture risk in a population of older persons.
  
  
  METHODS
  Serum interleukin 6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were measured in 1287 participants of the Longitudinal Aging Study Amsterdam (LASA), a population based study in a representative sample of older men and women (age 76 ± 6.7 years). Bone quality was measured by quantitative ultrasound measurements (QUS) at baseline and after 3 years at the calcaneus, and bone mineral density was measured by dual-energy X-ray absorptiometry (DXA) at the spine and hip in a subpopulation. Furthermore, the bone markers osteocalcin (OC) and urinary excretion of deoxypyridinoline (DPD) were determined. Incident clinical fractures were recorded during 6 years of follow-up.
  
  
  RESULTS
  Multivariable regression analyses revealed higher IL-6 and ESR levels were associated with lower quantitative ultrasound values in older men (β=-0.98; 95% CI -57.72 to -6.42, p<0.05) and (β=-0.221; 95% CI -15.39 to -3.27, p<0.05) respectively at baseline, but not in women. No significant associations were found between inflammatory markers and bone markers, bone loss at the spine or hips, fracture rate or time to fracture.
  
  
  CONCLUSIONS
  Elevated inflammatory markers are associated with impaired bone quality in older men, but not in women. No associations were found with the risk for fractures.
authors.affiliation: Amsterdam Rheumatology and Immunology Center, VU University Medical Center and Reade, The Netherlands. Electronic address: d.denuyl@vumc.nl.
authors.forename: Debby
authors.initials: D
authors.lastname: den Uyl
authors.affiliation: VU University Medical Center, EMGO institute for Health and Care Research, Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands.
authors.forename: Natasja M
authors.initials: NM
authors.lastname: van Schoor
authors.affiliation: VU University Medical Center, Department of Internal Medicine, Amsterdam, The Netherlands.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bravenboer
authors.affiliation: VU University Medical Center, Department of Internal Medicine, Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.affiliation: Amsterdam Rheumatology and Immunology Center, VU University Medical Center and Reade, The Netherlands.
authors.forename: Willem F
authors.initials: WF
authors.lastname: Lems
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood* / Q000473:pathology; D005260:Female; D050723:Fractures, Bone / Q000097:blood* / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D018836:Inflammation Mediators / Q000097:blood*; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010024:Osteoporosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000378:metabolism; D014463:Ultrasonography
chemical_list: D018836:Inflammation Mediators
keywords: Bone mineral density; C-reactive protein; Fractures; IL-6; Inflammation; Osteoporosis