A plasma protein-based risk score to predict hip fractures

Area of Science:

• Biomarkers
• Gerontology
• Epidemiology

Background:

• Hip fractures pose a significant health burden, necessitating accurate risk prediction for effective intervention.
• Current risk assessment tools can be improved with novel predictive markers.

Purpose of the Study:

• To develop and validate a novel protein-based risk score for predicting incident hip fractures.
• To assess the performance of this proteomic risk score compared to existing methods and risk factors.

Main Methods:

• Development of a protein-based risk score using an aptamer-based proteomic platform in the Cardiovascular Health Study.
• Validation in independent cohorts (Trøndelag Health Study, UK Biobank) using both aptamer- and antibody-based platforms.
• Comparison of the proteomic risk score's predictive ability against polygenic risk scores, bone mineral density, and the Fracture Risk Assessment Tool (FRAX).

Main Results:

• The developed proteomic risk score demonstrated significant association with incident hip fractures across validation cohorts.
• It improved hip fracture discrimination beyond the standard Fracture Risk Assessment Tool (FRAX).
• The proteomic risk score outperformed available polygenic risk scores and bone mineral density in prediction.

Conclusions:

• A novel protein-based risk score shows potential for improved hip fracture risk stratification.
• While demonstrating modest improvements, its clinical utility beyond FRAX with bone mineral density requires further investigation.