Division of Rheumatology, Department of Medicine, Augusta University, Augusta, GA, USA; Charlie Norwood Veterans Affairs Medical Center, Veterans Affairs Health Care System, Augusta, GA, USA.
Department of Biostatistics, University of Washington, Seattle, WA, USA.
Bone. 2022 Aug;161:116431. doi: 10.1016/j.bone.2022.116431. Epub 2022 May 13.
Gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) may adversely affect bone by inducing oxidative stress. Whether this translates into increased fracture risk in older adults is uncertain.
Determine the associations of plasma TMAO with hip fracture and bone mineral density (BMD) in older adults.
Cox hazard models and linear regression stratified by sex examined the associations of TMAO with hip fracture and BMD in the longitudinal cohort of the Cardiovascular Health Study.
5019 U.S. adults aged ≥65 years.
Plasma TMAO.
Incident hip fractures; total hip BMD dual x-ray absorptiometry in a subset (n = 1400).
Six hundred sixty-six incident hip fractures occurred during up to 26 years of follow-up (67,574 person-years). After multivariable adjustment, TMAO was not significantly associated with hip fracture (women: hazard ratio (HR) [95% confidence interval (CI)] of 1.00[0.92,1.09] per TMAO doubling; men: 1.12[0.95,1.33]). TMAO was also not associated with total hip BMD (women: BMD difference [95% CI] of 0.42 g/cm*100 [-0.34,1.17] per TMAO doubling; men: 0.19[-1.04,1.42]). In exploratory analyses, we found an interaction between body mass index (BMI) and the association of TMAO with hip fracture (P < 0.01). Higher TMAO was significantly associated with risk of hip fracture in adults with overweight or obesity (BMI ≥ 25) (HR [95% CI]:1.17[1.05,1.31]), but not normal or underweight.
Among older US men and women, TMAO was not significantly associated with risk of hip fracture or BMD overall. Exploratory analyses suggested a significant association between higher TMAO and hip fracture when BMI was elevated, which merits further study.
肠道微生物衍生代谢产物三甲胺 N-氧化物（TMAO）可能通过诱导氧化应激对骨骼产生不利影响。但这是否会导致老年人骨折风险增加尚不确定。
确定老年人血浆 TMAO 与髋部骨折和骨密度（BMD）之间的关系。
Cox 风险模型和按性别分层的线性回归分析了心血管健康研究纵向队列中 TMAO 与髋部骨折和 BMD 的关系。
5019 名年龄≥65 岁的美国成年人。
血浆 TMAO。
新发髋部骨折；在亚组中（n=1400）进行全髋关节 BMD 双能 X 射线吸收法测定。
在 26 年的随访期间发生了 666 例髋部骨折（67574 人年）。经多变量调整后，TMAO 与髋部骨折无显著相关性（女性：TMAO 翻倍时的风险比（HR）[95%置信区间（CI）]为 1.00[0.92,1.09]；男性：1.12[0.95,1.33]）。TMAO 与全髋关节 BMD 也无相关性（女性：TMAO 翻倍时 BMD 差值[95%CI]为 0.42g/cm*100[-0.34,1.17]；男性：0.19[-1.04,1.42]）。在探索性分析中，我们发现 BMI 与 TMAO 与髋部骨折之间的关联存在交互作用（P<0.01）。在超重或肥胖（BMI≥25）的成年人中，较高的 TMAO 与髋部骨折风险显著相关（HR[95%CI]：1.17[1.05,1.31]），而在正常体重或体重不足的成年人中则没有。
在美国老年男女中，TMAO 与髋部骨折或总体 BMD 风险无显著相关性。探索性分析表明，当 BMI 升高时，TMAO 与髋部骨折之间存在显著关联，这值得进一步研究。
