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Serum sclerostin and risk of hip fracture in older caucasian women

Arasu, A and Cawthon, PM and Lui, LY and Do, TP and Arora, PS and Cauley, JA and Ensrud, KE and Cummings, SR (2012) Serum sclerostin and risk of hip fracture in older caucasian women. Journal of Clinical Endocrinology and Metabolism, 97 (6). 2027 - 2032. ISSN 0021-972X

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Context: Sclerostin, a protein secreted by osteocytes, inhibits bone formation. Individuals with genetic mutations that decrease the availability of sclerostin have very high bone mass. Objective: The aim of this study was to examine the hypothesis that elevated serum sclerostin levels are associated with increased risk of hip fracture in older women. Design, Setting, and Participants: This was a case-cohort study of a prospective, community-based cohort of 9704 women aged 65 yr or older. Sclerostin levels were measured in serum collected in 1989-1990 in 228 women with incident hip fractures and 227 women in a randomly selected sample; average follow-up time was 9.8 yr. Results: Serum sclerostin levels were correlated with total hip bone mineral density (BMD; r=0.27, P<0.001). The risk of hip fracture increased across quartiles of serum sclerostin (test for trend, P< 0.001) and was significantly elevated among those in the fourth quartile (hazard risk 3.4, 95% confidence interval 1.7-7.0) compared with women in the lowest quartile, after adjusting for age, body mass index, estrogen use, history of fracture since age 50 yr, and total hip BMD. When dividing the cohort into eight groups by sclerostin quartile and median hip BMD, women with lower total hip BMD in the highest sclerostin quartile had a 22.3-fold (95% confidence interval 5.8-86.3) increased risk of fracture compared with women with higher total hip BMD in the lowest sclerostin quartile. Conclusions: We conclude that higher serum sclerostin levels are associated with a greater risk of hip fractures in older women. In addition, the risk of hip fracture is amplified when high sclerostin levels are combined with lower BMD. Copyright © 2012 by The Endocrine Society.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Arasu, A
Cawthon, PM
Lui, LY
Do, TP
Arora, PS
Cauley, JAJCauley@edc.pitt.eduJCAULEY
Ensrud, KE
Cummings, SR
Date: 1 June 2012
Date Type: Publication
Journal or Publication Title: Journal of Clinical Endocrinology and Metabolism
Volume: 97
Number: 6
Page Range: 2027 - 2032
DOI or Unique Handle: 10.1210/jc.2011-3419
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 0021-972X
Date Deposited: 03 Apr 2015 01:36
Last Modified: 04 Feb 2019 20:55


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