ECTS2013 Oral Communications Osteoporosis epidemiology and long term treatment complications (6 abstracts)
1Section of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 3Department of Public Health and Caring Sciences/Section of Geriatrics, Uppsala University, Uppsala, Sweden; 4Section of Clinical Pharmacology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Recent studies indicate a potential importance of the antioxidant α-tocopherol for bone and the development of sarcopenia. No longitudinal clinical fracture studies have been performed. We aimed to determine whether α-tocopherol intake or serum concentrations are associated with fracture risk in older women and men. We used data from two community-based cohorts, the Swedish Mammography Cohort (SMC; 61 433 women) and the Uppsala Longitudinal Study of Adult Men (ULSAM; 1138 men). Nutrient intakes were assessed with repeated food frequency questionnaires in the SMC and by dietary food recordings in the ULSAM cohort. Serum α-tocopherol analyses were done by HPLC. During follow-up, 14 738 women in the SMC experienced a first fracture at any site of which 3871 were hip fractures. A gradual increase in hip fracture rate was observed with lower intakes of α-tocopherol. In comparison with the highest quintile of intake, the lowest quintile intake had a multivariable-adjusted hazard ratio (HR) of 1.86 (95% CI 1.672.06). The corresponding HR of any fracture was 1.20 (95% CI 1.141.28). Moreover, α-tocopherol-containing supplement use was associated with a reduced rate of hip fracture (HR 0.78; 95% CI 0.650.93) and any type of fracture (HR 0.86; 95% CI 0.780.94). Compared with highest quintile of α-tocopherol intake in the ULSAM study, lower intakes were associated with a higher rate of hip fracture (multivariable-adjusted HR 3.33; 95% CI 1.437.76) and any type of fracture (HR 1.84; 95% CI 1.182.88). Each SD decrease in serum α-tocopherol conferred a HR for hip fracture of 1.58 (95% CI 1.132.22) and of 1.23 (95% CI 1.021.48) for any fracture. We conclude that a low intake and low serum levels of α-tocopherol are associated with an increased rate of fracture in elderly women and men.