Po-Yin Chang1, Ellen B Gold1, Jane A Cauley1, Wesley O Johnson1, Carrie Karvonen-Gutierrez1, Elizabeth A Jackson1, Kristine M Ruppert1, Jennifer S Lee1. 1. Division of Endocrinology, Gerontology, and Metabolism (P.-Y.C., J.S.L.), Department of Medicine, Stanford University School of Medicine, Stanford, California; Department of Public Health Sciences (E.B.G.), University of California, Davis, Davis, California; Department of Epidemiology (J.A.C., K.M.R.), University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania; Department of Statistics (W.O.J.), University of California, Irvine, Irvine, California; 5Department of Epidemiology (C.K.-G.), University of Michigan School of Public Health, Ann Arbor, Michigan; Division of Cardiovascular Medicine (E.A.J.), Department of Medicine, University of Michigan Health Systems, Ann Arbor, Michigan; Medical Services (J.S.L.), Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
Abstract
CONTEXT: Unfavorable lipid levels contribute to cardiovascular disease and may also harm bone health. OBJECTIVE: Our objective was to investigate relationships between fasting plasma lipid levels and incident fracture in midlife women undergoing the menopausal transition. DESIGN AND SETTING: This was a 13-year prospective, longitudinal study of multiethnic women in five US communities, with near-annual assessments. PARTICIPANTS: At baseline, 2062 premenopausal or early perimenopausal women who had no history of fracture were included. EXPOSURES: Fasting plasma total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol at baseline and follow-up visits 1 and 3-7. MAIN OUTCOME MEASURE(S): Incident nontraumatic fractures 1) 2 or more years after baseline, in relation to a single baseline level of lipids; and 2) 2-5 years later, in relation to time-varying lipid levels. Cox proportional hazards modelings estimated hazard ratios and 95% confidence interval (CI). RESULTS: Among the lipids, TG levels changed the most, with median levels increased by 16% during follow-up. An increase of 50 mg/dl in baseline TG level was associated with a 1.1-fold increased hazards of fracture (adjusted hazard ratio, 1.11; 95% CI, 1.04-1.18). Women with baseline TG higher than 300 mg/dl had an adjusted 2.5-fold greater hazards for fractures (95% CI, 1.13-5.44) than women with baseline TG lower than 150 mg/dl. Time-varying analyses showed a comparable TG level-fracture risk relationship. Associations between total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol levels and fractures were not observed. CONCLUSIONS: Midlife women with high fasting plasma TG had an increased risk of incident nontraumatic fracture. Secondary Abstract: Midlife women with fasting plasma triglyceride (TG) of at least 300 mg/dl had 2.5-fold greater hazards of fracture in 2 years later and onward, compared to those with TG below 150 mg/dl, in a multiethnic cohort. Time-varying analyses revealed comparable results.
CONTEXT: Unfavorable lipid levels contribute to cardiovascular disease and may also harm bone health. OBJECTIVE: Our objective was to investigate relationships between fasting plasma lipid levels and incident fracture in midlife women undergoing the menopausal transition. DESIGN AND SETTING: This was a 13-year prospective, longitudinal study of multiethnic women in five US communities, with near-annual assessments. PARTICIPANTS: At baseline, 2062 premenopausal or early perimenopausal women who had no history of fracture were included. EXPOSURES: Fasting plasma total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol at baseline and follow-up visits 1 and 3-7. MAIN OUTCOME MEASURE(S): Incident nontraumatic fractures 1) 2 or more years after baseline, in relation to a single baseline level of lipids; and 2) 2-5 years later, in relation to time-varying lipid levels. Cox proportional hazards modelings estimated hazard ratios and 95% confidence interval (CI). RESULTS: Among the lipids, TG levels changed the most, with median levels increased by 16% during follow-up. An increase of 50 mg/dl in baseline TG level was associated with a 1.1-fold increased hazards of fracture (adjusted hazard ratio, 1.11; 95% CI, 1.04-1.18). Women with baseline TG higher than 300 mg/dl had an adjusted 2.5-fold greater hazards for fractures (95% CI, 1.13-5.44) than women with baseline TG lower than 150 mg/dl. Time-varying analyses showed a comparable TG level-fracture risk relationship. Associations between total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol levels and fractures were not observed. CONCLUSIONS: Midlife women with high fasting plasma TG had an increased risk of incident nontraumatic fracture. Secondary Abstract: Midlife women with fasting plasma triglyceride (TG) of at least 300 mg/dl had 2.5-fold greater hazards of fracture in 2 years later and onward, compared to those with TG below 150 mg/dl, in a multiethnic cohort. Time-varying analyses revealed comparable results.
Authors: Kamil E Barbour; Robert Boudreau; Michelle E Danielson; Ada O Youk; Jean Wactawski-Wende; Nancy C Greep; Andrea Z LaCroix; Rebecca D Jackson; Robert B Wallace; Douglas C Bauer; Matthew A Allison; Jane A Cauley Journal: J Bone Miner Res Date: 2012-05 Impact factor: 6.741
Authors: Karen A Matthews; Sybil L Crawford; Claudia U Chae; Susan A Everson-Rose; Mary Fran Sowers; Barbara Sternfeld; Kim Sutton-Tyrrell Journal: J Am Coll Cardiol Date: 2009-12-15 Impact factor: 24.094
Authors: Carol A Derby; Sybil L Crawford; Richard C Pasternak; Maryfran Sowers; Barbara Sternfeld; Karen A Matthews Journal: Am J Epidemiol Date: 2009-04-08 Impact factor: 4.897
Authors: Joel S Finkelstein; Sarah E Brockwell; Vinay Mehta; Gail A Greendale; MaryFran R Sowers; Bruce Ettinger; Joan C Lo; Janet M Johnston; Jane A Cauley; Michelle E Danielson; Robert M Neer Journal: J Clin Endocrinol Metab Date: 2007-12-26 Impact factor: 5.958
Authors: Ulf Sennerby; Håkan Melhus; Rolf Gedeborg; Liisa Byberg; Hans Garmo; Anders Ahlbom; Nancy L Pedersen; Karl Michaëlsson Journal: JAMA Date: 2009-10-21 Impact factor: 56.272
Authors: Janina M Patsch; Xiaojuan Li; Thomas Baum; Samuel P Yap; Dimitrios C Karampinos; Ann V Schwartz; Thomas M Link Journal: J Bone Miner Res Date: 2013-08 Impact factor: 6.741
Authors: Elisabet Svenungsson; Iva Gunnarsson; Guo-Zhong Fei; Ingrid E Lundberg; Lars Klareskog; Johan Frostegård Journal: Arthritis Rheum Date: 2003-09
Authors: Joshua I Barzilay; Petra Buzkova; Lewis H Kuller; Jane A Cauley; Howard A Fink; Kerry Sheets; John A Robbins; Laura D Carbone; Rachel E Elam; Kenneth J Mukamal Journal: Am J Med Date: 2022-06-06 Impact factor: 5.928
Authors: Bernhard Haring; Carolyn J Crandall; Laura Carbone; Simin Liu; Wenjun Li; Karen C Johnson; Jean Wactawski-Wende; Aladdin H Shadyab; Margery L Gass; Victor Kamensky; Jane A Cauley; Sylvia Wassertheil-Smoller Journal: BMJ Open Date: 2019-04-24 Impact factor: 2.692
Authors: Taylor C Wallace; Shinyoung Jun; Peishan Zou; George P McCabe; Bruce A Craig; Jane A Cauley; Connie M Weaver; Regan L Bailey Journal: Menopause Date: 2020-08 Impact factor: 3.310