Association of serum phosphate, calcium and alkaline phosphatase with risk of incident fractures in healthy older adults.

Hussain, Sultana Monira; Seeman, Ego; Schneider, Hans G; Ebeling, Peter R; Barker, Anna L; Polkinghorne, Kevan; Newman, Anne B; Yu, Chenglong; Lacaze, Paul; Owen, Alice; Tran, Cammie; Nelson, Mark R; Woods, Robyn Lorraine; Yeap, Bu B; Clark, David; Beilin, Lawrence J; McNeil, John J

Hussain, Sultana Monira; Seeman, Ego; Schneider, Hans G; Ebeling, Peter R; Barker, Anna L; Polkinghorne, Kevan; Newman, Anne B; Yu, Chenglong; Lacaze, Paul; Owen, Alice; Tran, Cammie; Nelson, Mark R; Woods, Robyn Lorraine; Yeap, Bu B; Clark, David; Beilin, Lawrence J; McNeil, John J.

Afiliação

Hussain SM; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Seeman E; Department of Medical Education, Melbourne Medical School, The University of Melbourne, Victoria 3010 Australia.
Schneider HG; Department of Medical Education, Melbourne Medical School, The University of Melbourne, Victoria 3010 Australia.
Ebeling PR; Alfred Health, Melbourne, VIC, 3004, Australia.
Barker AL; School of Clinical Sciences, Monash University, Melbourne, VIC, 3168, Australia.
Polkinghorne K; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Newman AB; Silverchain, Melbourne, Victoria, Australia.
Yu C; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Lacaze P; Alfred Health, Melbourne, VIC, 3004, Australia.
Owen A; Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Tran C; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Nelson MR; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Woods RL; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Yeap BB; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
Clark D; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Beilin LJ; School of Public Health and Preventive Medicine, Monash University, Victoria 3004 Australia.
McNeil JJ; School of Medicine, University of Western Australia, Perth, Australia.

J Clin Endocrinol Metab ; 2024 Mar 01.

Article em En | MEDLINE | ID: mdl-38426788

ABSTRACT

ABSTRACT

BACKGROUND:

Aging increases fracture risk through bone loss and microarchitecture deterioration due to an age-related imbalance in bone resorption and formation during bone remodelling. We examined the associations between levels of phosphate, calcium, and alkaline phosphatase, and fracture risk in initially-healthy older individuals.

METHODS:

A post-hoc analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial recruited 16,703 Australian participants aged ≥70 years and 2,411 US participants aged ≥65 years. Analyses were conducted on ASPREE-Fracture substudy participants from Australia with serum calcium, phosphate, and alkaline phosphatase measurement. Fracture data were collected post-randomization. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs). Phosphate, calcium, and alkaline phosphatase were analysed in deciles (D1-D10), with deciles 4-7 (31-70%) as the reference category. Restricted cubic spline curves were used to identify nonlinear associations.

RESULTS:

Of the 9915 participants, 907 (9·2%) persons had incident fractures recorded over 3·9 (SD 1·4) years. In the fully adjusted model, males in the top decile (D10) of phosphate had 78% higher risk of incident fracture (HR 1·78, 95% CI 1·25-2·54). No such association was observed for females (HR 1·09, 95% CI 0·83-1·44). The population attributable fraction in men within the D10 phosphate category is 6·9%.