Poor trabecular microarchitecture at the distal radius in older men with increased concentration of high-sensitivity...

Area of Science:

• Bone biology and aging
• Inflammation and chronic disease
• Geriatric medicine

Background:

• Low-grade inflammation, measured by serum high-sensitivity C-reactive protein (hsCRP), is linked to increased fracture risk, independent of bone mineral density.
• The relationship between inflammation and bone health, particularly bone microarchitecture, requires further elucidation in aging men.

Purpose of the Study:

• To investigate the association between hsCRP levels and bone microarchitecture using high-resolution peripheral quantitative computed tomography (pQCT).
• To determine if bone microarchitecture mediates the relationship between hsCRP and fracture risk in men.

Main Methods:

• Cross-sectional study of 1,149 men aged 19-87 years.
• Measurement of serum hsCRP and bone microarchitecture at the distal radius and tibia via pQCT.
• Statistical analysis adjusting for age, bone mineral density, and other confounders.

Main Results:

• hsCRP levels increased with age until 72 years, then stabilized.
• In men aged ≥72, higher hsCRP (>5 mg/L) was associated with poorer trabecular bone microarchitecture at the distal radius (lower density, number; higher spacing).
• Fracture prevalence increased with hsCRP levels, and higher hsCRP remained an independent risk factor for fractures, even after adjusting for microarchitecture.

Conclusions:

• Elevated hsCRP is associated with altered trabecular bone structure at the distal radius in older men (≥72 years).
• Impaired bone microarchitecture does not appear to be the primary mechanism explaining the link between hsCRP and fracture risk.
• Inflammation may contribute to fracture risk through pathways other than direct effects on bone microarchitecture.