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Older men with low serum IGF-1 have an increased risk of incident fractures: the MrOS Sweden study.

Abstract

Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Insulin-like growth factor 1 (IGF-1) is a key determinant of bone mass, but the association between serum IGF-1 and incident fractures in men remains unclear. To determine the predictive value of serum IGF-1 for fracture risk in men, older men (n = 2902, mean age of 75 years) participating in the prospective, population-based Osteoporotic Fractures in Men (MrOS) Sweden study were followed for a mean of 3.3 years. Serum IGF-1 was measured at baseline by radioimmunoassay. Fractures occurring after the baseline visit were validated. In age-adjusted hazards regression analyses, serum IGF-1 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-1 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-1 and fracture risk. Serum IGF-1 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-1 have an increased fracture risk, especially for the two most important fracture types, hip and vertebral fractures. The association between serum IGF-1 and fracture risk is partly mediated via BMD.

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  • Authors+Show Affiliations

    ,

    Centre for Bone and Arthritis Research at the Sahlgrenska Academy, Institute of Medicine, University of Göteborg, Göteborg, Sweden. Claes.Ohlsson@medic.gu.se

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    MeSH

    Accidental Falls
    Aged
    Aged, 80 and over
    Aging
    Bone Density
    Comorbidity
    Fractures, Bone
    Glucocorticoids
    Hip Fractures
    Humans
    Incidence
    Insulin-Like Growth Factor I
    Male
    Osteoporosis
    Prevalence
    Proportional Hazards Models
    Prospective Studies
    Regression Analysis
    Risk Factors
    Spinal Fractures
    Sweden

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21433071

    Citation

    Ohlsson, Claes, et al. "Older Men With Low Serum IGF-1 Have an Increased Risk of Incident Fractures: the MrOS Sweden Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 26, no. 4, 2011, pp. 865-72.
    Ohlsson C, Mellström D, Carlzon D, et al. Older men with low serum IGF-1 have an increased risk of incident fractures: the MrOS Sweden study. J Bone Miner Res. 2011;26(4):865-72.
    Ohlsson, C., Mellström, D., Carlzon, D., Orwoll, E., Ljunggren, O., Karlsson, M. K., & Vandenput, L. (2011). Older men with low serum IGF-1 have an increased risk of incident fractures: the MrOS Sweden study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 26(4), pp. 865-72. doi:10.1002/jbmr.281.
    Ohlsson C, et al. Older Men With Low Serum IGF-1 Have an Increased Risk of Incident Fractures: the MrOS Sweden Study. J Bone Miner Res. 2011;26(4):865-72. PubMed PMID: 21433071.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Older men with low serum IGF-1 have an increased risk of incident fractures: the MrOS Sweden study. AU - Ohlsson,Claes, AU - Mellström,Dan, AU - Carlzon,Daniel, AU - Orwoll,Eric, AU - Ljunggren,Osten, AU - Karlsson,Magnus K, AU - Vandenput,Liesbeth, PY - 2011/3/25/entrez PY - 2011/3/25/pubmed PY - 2011/9/3/medline SP - 865 EP - 72 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 26 IS - 4 N2 - Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Insulin-like growth factor 1 (IGF-1) is a key determinant of bone mass, but the association between serum IGF-1 and incident fractures in men remains unclear. To determine the predictive value of serum IGF-1 for fracture risk in men, older men (n = 2902, mean age of 75 years) participating in the prospective, population-based Osteoporotic Fractures in Men (MrOS) Sweden study were followed for a mean of 3.3 years. Serum IGF-1 was measured at baseline by radioimmunoassay. Fractures occurring after the baseline visit were validated. In age-adjusted hazards regression analyses, serum IGF-1 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-1 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-1 and fracture risk. Serum IGF-1 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-1 have an increased fracture risk, especially for the two most important fracture types, hip and vertebral fractures. The association between serum IGF-1 and fracture risk is partly mediated via BMD. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/21433071/Older_men_with_low_serum_IGF_1_have_an_increased_risk_of_incident_fractures:_the_MrOS_Sweden_study_ L2 - https://doi.org/10.1002/jbmr.281 DB - PRIME DP - Unbound Medicine ER -