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Smoking, antioxidant vitamins, and the risk of hip fracture.

Abstract

Smoking increases the concentrations of free radicals, which have been suggested to be involved in bone resorption. We examined whether the dietary intake of antioxidant vitamins may modify the increased hip fracture risk associated with smoking. We prospectively studied 66,651 women who were 40-76 years of age. Forty-four of the cohort members who sustained a first hip fracture within 2-64 months of follow-up (n = 247) and 93 out of 873 age-matched controls were current smokers. Information on diet was obtained by a validated food-frequency questionnaire. The relative risk of hip fracture for current versus never smokers was analyzed in relation to the dietary intake of antioxidant vitamins stratified into two categories (low/high), where median intakes among the controls were used as cut-off points. After adjustment for major osteoporosis risk factors, the odds ratio (OR) for hip fracture among current smokers with a low intake of vitamin E was 3.0 (95% confidence interval 1.6-5.4) and of vitamin C 3.0 (1.6-5.6). In contrast, the OR decreased to 1.1 (0.5-2.4) and 1.4 (0.7-3.0) with high intakes of vitamin E and C, respectively. This effect was not seen for beta-carotene, selenium, calcium, or vitamin B6. In current smokers with a low intake of both vitamins E and C, the OR increased to 4.9 (2.2-11.0). The influence of the intake of these two antioxidant vitamins on hip fracture risk was less pronounced in former smokers. Our results suggest a role for oxidant stress in the adverse effects on the skeleton of smoking, and that an insufficient dietary intake of vitamin E and C may substantially increase the risk of hip fracture in current smokers, whereas a more adequate intake seems to be protective.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, University Hospital, Uppsala, Sweden.

    , , ,

    Source

    MeSH

    Adult
    Aged
    Antioxidants
    Ascorbic Acid
    Case-Control Studies
    Female
    Hip Fractures
    Humans
    Middle Aged
    Prospective Studies
    Risk Factors
    Smoking
    Surveys and Questionnaires
    Vitamin E

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    9893075

    Citation

    Melhus, H, et al. "Smoking, Antioxidant Vitamins, and the Risk of Hip Fracture." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 14, no. 1, 1999, pp. 129-35.
    Melhus H, Michaëlsson K, Holmberg L, et al. Smoking, antioxidant vitamins, and the risk of hip fracture. J Bone Miner Res. 1999;14(1):129-35.
    Melhus, H., Michaëlsson, K., Holmberg, L., Wolk, A., & Ljunghall, S. (1999). Smoking, antioxidant vitamins, and the risk of hip fracture. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 14(1), pp. 129-35.
    Melhus H, et al. Smoking, Antioxidant Vitamins, and the Risk of Hip Fracture. J Bone Miner Res. 1999;14(1):129-35. PubMed PMID: 9893075.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Smoking, antioxidant vitamins, and the risk of hip fracture. AU - Melhus,H, AU - Michaëlsson,K, AU - Holmberg,L, AU - Wolk,A, AU - Ljunghall,S, PY - 1999/1/20/pubmed PY - 1999/1/20/medline PY - 1999/1/20/entrez SP - 129 EP - 35 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 - 14 IS - 1 N2 - Smoking increases the concentrations of free radicals, which have been suggested to be involved in bone resorption. We examined whether the dietary intake of antioxidant vitamins may modify the increased hip fracture risk associated with smoking. We prospectively studied 66,651 women who were 40-76 years of age. Forty-four of the cohort members who sustained a first hip fracture within 2-64 months of follow-up (n = 247) and 93 out of 873 age-matched controls were current smokers. Information on diet was obtained by a validated food-frequency questionnaire. The relative risk of hip fracture for current versus never smokers was analyzed in relation to the dietary intake of antioxidant vitamins stratified into two categories (low/high), where median intakes among the controls were used as cut-off points. After adjustment for major osteoporosis risk factors, the odds ratio (OR) for hip fracture among current smokers with a low intake of vitamin E was 3.0 (95% confidence interval 1.6-5.4) and of vitamin C 3.0 (1.6-5.6). In contrast, the OR decreased to 1.1 (0.5-2.4) and 1.4 (0.7-3.0) with high intakes of vitamin E and C, respectively. This effect was not seen for beta-carotene, selenium, calcium, or vitamin B6. In current smokers with a low intake of both vitamins E and C, the OR increased to 4.9 (2.2-11.0). The influence of the intake of these two antioxidant vitamins on hip fracture risk was less pronounced in former smokers. Our results suggest a role for oxidant stress in the adverse effects on the skeleton of smoking, and that an insufficient dietary intake of vitamin E and C may substantially increase the risk of hip fracture in current smokers, whereas a more adequate intake seems to be protective. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/9893075/Smoking_antioxidant_vitamins_and_the_risk_of_hip_fracture_ L2 - https://doi.org/10.1359/jbmr.1999.14.1.129 DB - PRIME DP - Unbound Medicine ER -