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Older men with low serum IGF-I have an increased risk of incident fractures: The MrOS Sweden study.

Journal article
Authors Claes Ohlsson
Dan Mellström
Daniel Carlzon
Eric Orwoll
Östen Ljunggren
Magnus K Karlsson
Liesbeth Vandenput
Published in Journal of bone and mineral research
Volume 26
Issue 4
Pages 865-872
ISSN 1523-4681
Publication year 2011
Published at Centre for Bone and Arthritis Research
Pages 865-872
Language en
Links dx.doi.org/10.1002/jbmr.281
Keywords POPULATION STUDIES; INSULIN-LIKE GROWTH FACTOR 1; AGING; MEN; FRACTURE
Subject categories Endocrinology

Abstract

Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Insulin-like growth factor-I (IGF-I) is a key determinant of bone mass but the association between serum IGF-I and incident fractures in men remains unclear.To determine the predictive value of serum IGF-I for fracture risk in men, older men (n=2902, mean 75 years of age), participating in the prospective, population-based Osteoporotic Fractures in Men (MrOS) Sweden study, were followed for a mean of 3.3 years. Serum IGF-I was measured at baseline by radioimmunoassay. Fractures occurring after the baseline visit were validated.In age-adjusted hazards regression analyses, serum IGF-I associated inversely with risk of all fractures (hazard ratio [HR] per SD decrease 1.23; 95% confidence interval [CI] 1.07-1.41), hip fractures (HR per SD decrease 1.45; 95% CI, 1.07-1.97) and clinical vertebral fractures (HR per SD decrease 1.40; 95% CI, 1.10-1-78). The predictive role of serum IGF-I for fracture risk was unaffected by adjustment for height, weight, prevalent fractures, falls, and major prevalent diseases. Further adjustment for bone mineral density (BMD) resulted in an attenuated but still significant association between serum IGF-I and fracture risk. Serum IGF-I below but not above the median was inversely related to fracture incidence. The population attributable risk proportion was 7.5% for all fractures and 22.9 % for hip fractures.Taken together, older men with low serum IGF-I have an increased fracture risk, especially for the two most important fracture types, hip and vertebral fractures. The association between serum IGF-I and fracture risk is partly mediated via BMD.

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