C-reactive protein and risk of fracture: a systematic review and dose-response meta-analysis of prospective cohort studies.

UNLABELLED: This study systematically reviews prospective cohort studies evaluating the relationship between C-reactive protein (CRP) concentrations and subsequent fracture risk. The positive association cannot completely explain the existing evidence, and further studies are needed to demonstrate the shape of the association. INTRODUCTION: We aimed to perform a systematic review and dose-response meta-analysis of published prospective studies evaluating associations of high-sensitivity CRP (hs-CRP) levels with fracture risk in general populations. METHODS: We identified relevant studies by searching MEDLINE and EMBASE databases from their inception to May 20, 2014. We included published prospective studies evaluating the associations of hs-CRP levels with risk of fracture in general populations. Two reviewers working independently abstracted the data. RESULTS: Eight prospective cohort studies involving 34,840 participants and 3,407 incident fracture events were eligible for the present analyses. A meta-analysis of six prospective studies showed that the overall risk for incident fracture in a comparison of individuals in the top tertile with those in the bottom tertile of baseline hs-CRP levels was 2.14 [95% confidence interval (CI) 1.51-3.05, I(2) = 62.3%]. The moderate heterogeneous disappeared when one study was excluded. However, the remaining two studies reported inconsistent results. One study with the biggest sample size showed a U-shaped association for CRP and fracture risk (the association was positive when CRP > 1 mg/L). Similarly, another study reported that per doubling of CRP was positive only when CRP > 3 mg/L. CONCLUSION: In summary, the present analysis showed that the relationship between CRP concentrations and subsequent fracture risk is still inconsistent. The positive association cannot completely explain the existing evidence, and further larger prospective cohorts with more power are needed to demonstrate the shape of the association, especially for the relatively low CRP concentrations, such as less than 3 mg/L.

[Epidemiological characteristics of preserved vegetable intake in adults in 10 areas of China].

Objective: To describe the epidemiological characteristics of intakes of different types of preserved vegetables in participants from the China Kadoorie Biobank (CKB). Methods: The CKB project conducted baseline survey, the first resurvey, and the second resurvey during 2004-2008, 2008, and 2013-2014, respectively. According to the average intake levels of salted and sour pickled vegetables in the second resurvey, the 10 survey areas were classified as the area where people mainly consumed salted vegetables, the area where people mainly consumed sour pickled vegetables, and the area where people rarely consumed preserved vegetables. For the first two areas, logistic regression model was used to describe the temporal trends and population distribution of preserved vegetable intake and analyze the distribution of other dietary factors. Results: The area where people mainly consumed salted vegetables included Qingdao, Harbin, Suzhou, and Zhejiang (baseline participant number: 204 036), while the area where people mainly consumed sour pickled vegetables included Gansu and Sichuan (baseline participant number: 105 573). In the area where people mainly consumed salted vegetables, the average intake frequencies of preserved vegetables was 3.1, 3.3, and 1.8 days/week in the baseline survey, the first resurvey, and the second resurvey, respectively, showing a declining trend (P<0.001). Similarly, the average intake frequencies of preserved vegetables were 2.8, 2.7, and 1.6 days/week in the baseline survey, the first resurvey and the second resurvey in the area where people mainly consumed sour pickled vegetables (P<0.001). At baseline survey, the married and those had lower education level tended to have more preserved vegetable intakes in both areas (P<0.001). In the area where people mainly consumed salted vegetables, the elderly had higher frequency of preserved vegetable intake (P<0.001), which was converse in the area where people mainly consumed sour pickled vegetables. In the participants with higher frequency of preserved vegetable intake, more people consumed spicy food daily and preferred salty food (P<0.05). Conclusions: The area and population specific differences in the type and frequency of preserved vegetable intake were observed in adults in the CKB project in China. Besides, the average level of preserved vegetable intake showed a declining trend. Preserved vegetable intake might be associated with other dietary habits.

Hindlimb suspension inhibits air-righting due to altered recruitment of neck and back muscles in rats.

Effects of 9-week hindlimb suspension and 8-week recovery on air-righting reaction in response to drop from a supine position were studied in adult rats. The righting time in rats at the end of suspension (approximately 220 ms) was longer than the age-matched controls (approximately 120 ms, p <0.05). The unloading-related change in righting time was accompanied by lowered activities of electromyogram (EMG) and altered recruitment of both neck and back muscles at a specific stage of drop. After 8 weeks of reambulation, righting time recovered toward the control level (approximately 153 ms, p <0.05), but the EMG activity of back muscle was still less than controls. In contrast, the EMG of neck muscle during fall was even increased. The differences in the characteristics of the muscle fibers between two groups were minor. It is suggested that inhibition of recruitment, rather than the changes in the fiber characteristics, of neck and back muscles is one of the major causes of the slow air-righting.