Cystatin C and risk of hip fractures in older women. (21st May 2013)

• Record Type: Journal Article
• Authors: Ensrud, Kristine E; Parimi, Neeta; Cauley, Jane A; Ishani, Areef; Slinin, Yelena; Hillier, Teresa A; Taylor, Brent C; Steffes, Michael; Cummings, Steven R
• Is Part Of: Journal of bone and mineral research. Volume 28:Number 6(2013:Jun.)
• Page Start: 1275
• Page End: 1282
• Publication Date: 2013-05-21
• Subjects: Bones -- Metabolism -- Periodicals; Mineral metabolism -- Periodicals; 612.392
• DOI: 10.1002/jbmr.1858
• Languages: English
• ISSNs: 0884-0431

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>ABSTRACT</title> <sec id="jbmr1858-sec-0001" sec-type="section"> <p>To test the hypothesis that older women with higher cystatin C are at increased risk of hip fracture independent of traditional risk factors including hip bone mineral density (BMD), we performed a case‐cohort analysis nested in a cohort of 4709 white women attending a Year 10 (1997–1998) examination of the Study of Osteoporotic Fractures that included a random sample of 1170 women and the first 300 women with incident hip fracture occurring after Year 10 examination. Serum cystatin C and creatinine were measured in Year 10 sera. In a model adjusted for age, clinical site, body mass index, and total hip BMD, higher cystatin C was associated with an increased risk of hip fracture (<italic>p</italic> for linear trend 0.008) with women in quartile 4 having a 1.9‐fold higher risk (hazard ratio [HR] 1.91; 95% confidence interval [CI], 1.24–2.95) compared with those in quartile 1 (referent group). Further adjustment for additional risk factors only slightly attenuated the association; the risk for hip fracture was 1.7‐fold higher (HR 1.74; 95% CI, 1.11–2.72) in women in quartile 4 compared with those in quartile 1. In contrast, neither serum creatinine nor creatinine‐based estimated glomerular filtration rate (eGFR<sub>Cr</sub>) were associated with risk of hip fracture. Older women with higher cystatin C, but not higher serum creatinine or lower eGFR<sub>Cr</sub>, have an increased risk of hip fracture independent of traditional risk factors. These findings suggest that cystatin C may be a promising biomarker for identification of older adults at high risk of hip fracture.</p> </sec> </abstract>