Greendale Gail A, Jackson Nicholas J, Han Weijuan, Huang MeiHua, Cauley Jane A, Karvonen-Gutierrez Carrie, Karlamangla Arun S
Department of Medicine, Division of Geriatrics University of California, Los Angeles (UCLA) Los Angeles CA USA.
Department of Medicine, Division of General Internal Medicine & Health Services Research University of California, Los Angeles (UCLA) Los Angeles CA USA.
JBMR Plus. 2021 Mar 16;5(4):e10480. doi: 10.1002/jbm4.10480. eCollection 2021 Apr.
This longitudinal cohort study's aim was to detect whether larger increases in C-reactive protein (CRP) predict greater amounts of subsequent bone loss in women transitioning from premenopause to postmenopause. Participants were initially 42 to 52 years of age and premenopausal or early perimenopausal. The sample included 1431 women who were not using hormone therapy and whose CRP values were not consistent with acute inflammation. Individual fixed effects (IFE) models estimated the association of log CRP with subsequent bone mineral density (BMD) decline rate, adjusted for menopause transition (MT) stage (1: premenopausal or early perimenopausal; 2: late perimenopausal or early postmenopausal; or 3: late postmenopausal), body mass index, diabetes, smoking, alcohol, bone active medications, and anti-inflammatory medications. BMD decline at both the lumbar spine (LS) and femoral neck (FN) was faster for observations made in MT stage 2 than that during other stages (all < .001). In adjusted IFE models, MT stage modified the relation between increase in CRP and BMD decline rate (interaction values <.05). Each within-woman doubling of CRP was associated with a 0.09% faster yearly decline in FN BMD in MT stages 1 ( = .006) and 3 ( = .03), and 0.10% faster decline in LS BMD in MT stage 3 only ( = .007). Within-woman increases in CRP in premenopause and early perimenopause and in late postmenopause predict faster BMD decline in the next ~2 years, but the magnitude of CRP's effect is small. © 2021 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
这项纵向队列研究的目的是检测在从绝经前过渡到绝经后的女性中，C反应蛋白（CRP）水平的较大升高是否预示着随后更多的骨质流失。参与者最初年龄在42至52岁之间，处于绝经前或围绝经期早期。样本包括1431名未使用激素疗法且CRP值与急性炎症不一致的女性。个体固定效应（IFE）模型估计了log CRP与随后骨矿物质密度（BMD）下降率之间的关联，并对绝经过渡（MT）阶段（1：绝经前或围绝经期早期；2：围绝经期晚期或绝经后早期；或3：绝经后晚期）、体重指数、糖尿病、吸烟、饮酒、骨活性药物和抗炎药物进行了调整。在MT阶段2观察到的腰椎（LS）和股骨颈（FN）的BMD下降速度比其他阶段更快（均<0.001）。在调整后的IFE模型中，MT阶段改变了CRP升高与BMD下降率之间的关系（交互作用值<0.05）。在MT阶段1（P = 0.006）和3（P = 0.03），女性体内CRP每翻倍，FN BMD每年下降速度加快0.09%，仅在MT阶段3，LS BMD下降速度加快0.10%（P = 0.007）。绝经前、围绝经期早期和绝经后晚期女性体内CRP的升高预示着在接下来约2年中BMD下降更快，但CRP的影响幅度较小。© 2021作者。由Wiley Periodicals LLC代表美国骨与矿物质研究学会出版。
