Correlates of T50 and relationships with bone mineral density in community-living older men: the osteoporotic fractures in men (MrOS) study

PURPOSE

T₅₀ is a novel serum-based marker that assesses the propensity of calcification in serum. Shorter T₅₀ indicates greater propensity to calcify and it has been associated to cardiovascular disease (CVD) and mortality among patients with kidney disease. In the general population, neither the correlates of T₅₀ nor the relationships of T₅₀ with bone mineral density (BMD) are known.

METHODS

We performed a nested cross-sectional study selecting 150 individuals at random among participants from the Osteoporotic Fractures in Men (MrOS) Study, a study of community-living older men. We categorized individuals into tertiles of T₅₀ and compared demographics and disease indicators across tertiles. We utilized linear regression to evaluate the cross-sectional association between T₅₀ and hip and spine BMD in multivariable models.

RESULTS

Older age was associated with shorter T₅₀. Kidney function tended to be lower in those with shorter T₅₀ and the prevalence of CVD and peripheral arterial disease in those with shorter T₅₀, albeit these findings did not achieve statistical significance. We found no statistically significant associations between T₅₀ and total hip or total spine BMD in either unadjusted or multivariable adjusted models.

CONCLUSIONS

T₅₀, a novel indicator of serum calcification propensity, is not associated with BMD in community-living older men. Future larger studies should determine if T₅₀ may give insights to CVD in the general population above and beyond traditional risk factors.

The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study

There is limited wrist fracture information on men. Our goal was to calculate frequency and identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. We confirmed that fracture history and certain medications are predictors, and identified novel predictors including markers of kidney function and physical performance.

INTRODUCTION

To calculate the incidence of wrist fractures and their risk factors in older community-dwelling men from the US Osteoporotic Fractures in Men (MrOS) study.

METHODS

Using triannual postcards, we identified incident wrist fractures (centrally confirmed by radiology) in men aged ≥ 65. Potential risk factors included the following: demographics, lifestyle, bone mineral density (BMD), selected medications, biomarkers, and physical function and performance measures. Both baseline and time-varying models were adjusted for age, race/ethnicity, MrOS geographic location, and competing mortality risks.

RESULTS

We observed 97 incident wrist fractures among 5875 men followed for an average of 10.8 years. The incidence of wrist fracture was 1.6 per 1000 person-years overall and ranged from 1.0 among men aged 65-69 to 2.4 among men age ≥ 80. Significant predictors included the following: fracture history after age 50 [hazard ratio (95% CI): 2.48 (1.65, 3.73)], high serum phosphate [1.25 (1.02, 1.53)], use of selective serotonin receptor inhibitor (SSRI) [3.60 (1.96, 6.63), decreased right arm BMD [0.49 (0.37, 0.65) per SD increase], and inability to perform the grip strength test [3.38 (1.24, 9.25)]. We did not find associations with factors commonly associated with wrist and other osteoporosis fractures like falls, diabetes, calcium and vitamin D intake, and alcohol intake.

CONCLUSIONS

Among these older, community-dwelling men, we confirmed that fracture history is a strong predictor of wrist fractures in men. Medications such as SSRIs and corticosteroids also play a role in wrist fracture risk. We identified novel risk factors including kidney function and the inability to perform the grip strength test.