Skip to main content
Top
Published in: Osteoporosis International 7/2014

01-07-2014 | Original Article

Waning predictive value of serum adiponectin for fracture risk in elderly men: MrOS Sweden

Authors: H. Johansson, A. Odén, M. K. Karlsson, E. McCloskey, J. A. Kanis, C. Ohlsson, D. Mellström

Published in: Osteoporosis International | Issue 7/2014

Login to get access

Abstract

Summary

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.

Introduction

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.

Conclusion

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.
Literature
1.
go back to reference Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis (1993). Am J Med 94 (6):646–650. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis (1993). Am J Med 94 (6):646–650.
2.
go back to reference Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group (1994). World Health Organ Tech Rep Ser 843:1–129 Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group (1994). World Health Organ Tech Rep Ser 843:1–129
3.
go back to reference Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary health-care level, Technical Report. WHO Collaborating Centre, University of Sheffield, UK Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary health-care level, Technical Report. WHO Collaborating Centre, University of Sheffield, UK
4.
go back to reference Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ 3rd, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18(8):1033–1046PubMedCrossRef Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ 3rd, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18(8):1033–1046PubMedCrossRef
8.
go back to reference Johansson H, Oden A, Lerner UH, Jutberger H, Lorentzon M, Barrett-Connor E, Karlsson MK, Ljunggren O, Smith U, McCloskey E, Kanis JA, Ohlsson C, Mellstrom D (2012) High serum adiponectin predicts incident fractures in elderly men: osteoporotic fractures in men (MrOS) Sweden. J Bone Miner Res 27(6):1390–1396. doi:10.1002/jbmr.1591 PubMedCrossRef Johansson H, Oden A, Lerner UH, Jutberger H, Lorentzon M, Barrett-Connor E, Karlsson MK, Ljunggren O, Smith U, McCloskey E, Kanis JA, Ohlsson C, Mellstrom D (2012) High serum adiponectin predicts incident fractures in elderly men: osteoporotic fractures in men (MrOS) Sweden. J Bone Miner Res 27(6):1390–1396. doi:10.​1002/​jbmr.​1591 PubMedCrossRef
9.
go back to reference Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26(5):569–585. doi:10.1016/j.cct.2005.05.006 PubMedCrossRef Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26(5):569–585. doi:10.​1016/​j.​cct.​2005.​05.​006 PubMedCrossRef
10.
go back to reference Mellstrom D, Vandenput L, Mallmin H, Holmberg AH, Lorentzon M, Oden A, Johansson H, Orwoll ES, Labrie F, Karlsson MK, Ljunggren O, Ohlsson C (2008) Older men with low serum estradiol and high serum SHBG have an increased risk of fractures. J Bone Miner Res 23(10):1552–1560. doi:10.1359/jbmr.080518 PubMedCrossRef Mellstrom D, Vandenput L, Mallmin H, Holmberg AH, Lorentzon M, Oden A, Johansson H, Orwoll ES, Labrie F, Karlsson MK, Ljunggren O, Ohlsson C (2008) Older men with low serum estradiol and high serum SHBG have an increased risk of fractures. J Bone Miner Res 23(10):1552–1560. doi:10.​1359/​jbmr.​080518 PubMedCrossRef
11.
go back to reference Mellstrom D, Johnell O, Ljunggren O, Eriksson AL, Lorentzon M, Mallmin H, Holmberg A, Redlund-Johnell I, Orwoll E, Ohlsson C (2006) Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden. J Bone Miner Res 21(4):529–535. doi:10.1359/jbmr.060110 PubMedCrossRef Mellstrom D, Johnell O, Ljunggren O, Eriksson AL, Lorentzon M, Mallmin H, Holmberg A, Redlund-Johnell I, Orwoll E, Ohlsson C (2006) Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden. J Bone Miner Res 21(4):529–535. doi:10.​1359/​jbmr.​060110 PubMedCrossRef
12.
go back to reference Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427PubMedCrossRef Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427PubMedCrossRef
13.
go back to reference Breslow NE, Day NE (1987) Statistical methods in cancer research. IARC Sci Publ No 32 Volume II:131–135 Breslow NE, Day NE (1987) Statistical methods in cancer research. IARC Sci Publ No 32 Volume II:131–135
14.
go back to reference Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19(4):385–397PubMedCentralPubMedCrossRef Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19(4):385–397PubMedCentralPubMedCrossRef
17.
go back to reference Kanazawa I, Yamaguchi T, Yamamoto M, Yamauchi M, Yano S, Sugimoto T (2009) Relationships between serum adiponectin levels versus bone mineral density, bone metabolic markers, and vertebral fractures in type 2 diabetes mellitus. Eur J Endocrinol 160(2):265–273. doi:10.1530/eje-08-0642 PubMedCrossRef Kanazawa I, Yamaguchi T, Yamamoto M, Yamauchi M, Yano S, Sugimoto T (2009) Relationships between serum adiponectin levels versus bone mineral density, bone metabolic markers, and vertebral fractures in type 2 diabetes mellitus. Eur J Endocrinol 160(2):265–273. doi:10.​1530/​eje-08-0642 PubMedCrossRef
18.
go back to reference Johnell O, Oden A, Caulin F, Kanis JA (2001) Acute and long-term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int 12(3):207–214PubMedCrossRef Johnell O, Oden A, Caulin F, Kanis JA (2001) Acute and long-term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int 12(3):207–214PubMedCrossRef
20.
go back to reference Johansson H, Oden A, Karlsson MK, Rosengren B, Ljunggren O, McCloskey E, Kanis J, Ohlsson C, Mellstrom D (2013) FRAX predicts future falls in elderly men. MrOs Sweden. JBMR 28((Suppl 1):S166 Johansson H, Oden A, Karlsson MK, Rosengren B, Ljunggren O, McCloskey E, Kanis J, Ohlsson C, Mellstrom D (2013) FRAX predicts future falls in elderly men. MrOs Sweden. JBMR 28((Suppl 1):S166
21.
go back to reference Johansson H, Oden A, Kanis J, McCloskey E, Lorentzon M, Ljunggren O, Karlsson MK, Thorsby PM, Tivesten A, Barrett-Connor E, Ohlsson C, Mellstrom D (2011) Low serum vitamin D is associated with increased mortality in elderly men: MrOS Sweden. Osteoporos Int. doi:10.1007/s00198-011-1809-5 PubMedCentral Johansson H, Oden A, Kanis J, McCloskey E, Lorentzon M, Ljunggren O, Karlsson MK, Thorsby PM, Tivesten A, Barrett-Connor E, Ohlsson C, Mellstrom D (2011) Low serum vitamin D is associated with increased mortality in elderly men: MrOS Sweden. Osteoporos Int. doi:10.​1007/​s00198-011-1809-5 PubMedCentral
22.
go back to reference Luukinen H, Kakonen SM, Pettersson K, Koski K, Laippala P, Lovgren T, Kivela SL, Vaananen HK (2000) Strong prediction of fractures among older adults by the ratio of carboxylated to total serum osteocalcin. J Bone Miner Res 15(12):2473–2478. doi:10.1359/jbmr.2000.15.12.2473 PubMedCrossRef Luukinen H, Kakonen SM, Pettersson K, Koski K, Laippala P, Lovgren T, Kivela SL, Vaananen HK (2000) Strong prediction of fractures among older adults by the ratio of carboxylated to total serum osteocalcin. J Bone Miner Res 15(12):2473–2478. doi:10.​1359/​jbmr.​2000.​15.​12.​2473 PubMedCrossRef
23.
go back to reference Ivaska KK, Gerdhem P, Vaananen HK, Akesson K, Obrant KJ (2010) Bone turnover markers and prediction of fracture: a prospective follow-up study of 1040 elderly women for a mean of 9 years. J Bone Miner Res 25(2):393–403. doi:10.1359/jbmr.091006 PubMedCrossRef Ivaska KK, Gerdhem P, Vaananen HK, Akesson K, Obrant KJ (2010) Bone turnover markers and prediction of fracture: a prospective follow-up study of 1040 elderly women for a mean of 9 years. J Bone Miner Res 25(2):393–403. doi:10.​1359/​jbmr.​091006 PubMedCrossRef
24.
go back to reference Ivaska K, McGuigan F, Obrant K, Gerdhem P, Akesson K (2013) Bone turnover markers and prediction of fractures in a 15-year follow-up study of elderly women. JBMR 28(Suppl 1):s34 Ivaska K, McGuigan F, Obrant K, Gerdhem P, Akesson K (2013) Bone turnover markers and prediction of fractures in a 15-year follow-up study of elderly women. JBMR 28(Suppl 1):s34
26.
go back to reference Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20(7):1185–1194. doi:10.1359/JBMR.050304 PubMedCrossRef Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20(7):1185–1194. doi:10.​1359/​JBMR.​050304 PubMedCrossRef
Metadata
Title
Waning predictive value of serum adiponectin for fracture risk in elderly men: MrOS Sweden
Authors
H. Johansson
A. Odén
M. K. Karlsson
E. McCloskey
J. A. Kanis
C. Ohlsson
D. Mellström
Publication date
01-07-2014
Publisher
Springer London
Published in
Osteoporosis International / Issue 7/2014
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-014-2654-0

Other articles of this Issue 7/2014

Osteoporosis International 7/2014 Go to the issue