Trimethylamine N-oxide and hip fracture and bone mineral density in older adults: The cardiovascular health study

被引:13
作者
Elam, Rachel E. [1 ]
Buzkova, Petra [2 ]
Barzilay, Joshua, I [3 ]
Wang, Zeneng [4 ]
Nemet, Ina [4 ]
Budoff, Matthew J. [5 ]
Cauley, Jane A. [6 ]
Fink, Howard A. [7 ]
Lee, Yujin [8 ]
Robbins, John A. [9 ]
Wang, Meng [10 ]
Hazen, Stanley L. [4 ,11 ]
Mozaffarian, Dariush [10 ]
Carbone, Laura D. [1 ,12 ]
机构
[1] Augusta Univ, Dept Med, Div Rheumatol, Augusta, GA 30912 USA
[2] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
[3] Emory Univ, Div Endocrinol, Kaiser Permanente Georgia, Sch Med, Atlanta, GA 30322 USA
[4] Cleveland Clin, Dept Cardiovasc & Metab Sci, Cleveland, OH 44106 USA
[5] Univ Calif Los Angeles, Dept Cardiol & Med, Los Angeles, CA USA
[6] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA
[7] Vet Affairs Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Minneapolis, MN USA
[8] Myongji Univ, Dept Food & Nutr, Yongin, South Korea
[9] Univ Calif Davis, Dept Med, Modesto, CA USA
[10] Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA
[11] Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH 44106 USA
[12] Vet Affairs Hlth Care Syst, Charlie Norwood Vet Affairs Med Ctr, Augusta, GA USA
关键词
Trimethylamine N-oxide; Gut microbiome; Bone mineral density; Hip fracture; Osteoporosis; Animal food; OXIDATIVE STRESS; ENDOTHELIAL DYSFUNCTION; DEPENDENT METABOLITE; TMAO; OSTEOPOROSIS; ASSOCIATION; MICROBIOME; FRAILTY; WOMEN; RISK;
D O I
10.1016/j.bone.2022.116431
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: Gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) may adversely affect bone by inducing oxidative stress. Whether this translates into increased fracture risk in older adults is uncertain. Objective: Determine the associations of plasma TMAO with hip fracture and bone mineral density (BMD) in older adults. Design and setting: Cox hazard models and linear regression stratified by sex examined the associations of TMAO with hip fracture and BMD in the longitudinal cohort of the Cardiovascular Health Study. Participants: 5019 U.S. adults aged >= 65 years. Exposure: Plasma TMAO. Main Outcome Measures: Incident hip fractures; total hip BMD dual x-ray absorptiometry in a subset (n = 1400). Results: Six hundred sixty-six incident hip fractures occurred during up to 26 years of follow-up (67,574 personyears). After multivariable adjustment, TMAO was not significantly associated with hip fracture (women: hazard ratio (HR) [95% confidence interval (CI)] of 1.00[0.92,1.09] per TMAO doubling; men: 1.12[0.95,1.33]). TMAO was also not associated with total hip BMD (women: BMD difference [95% CI] of 0.42 g/cm(2)*100 [ 0.34,1.17] per TMAO doubling; men: 0.19[ 1.04,1.42]). In exploratory analyses, we found an interaction between body mass index (BMI) and the association of TMAO with hip fracture (P < 0.01). Higher TMAO was significantly associated with risk of hip fracture in adults with overweight or obesity (BMI >= 25) (HR [95% CI]:1.17 [1.05,1.31]), but not normal or underweight. Conclusions: Among older US men and women, TMAO was not significantly associated with risk of hip fracture or BMD overall. Exploratory analyses suggested a significant association between higher TMAO and hip fracture when BMI was elevated, which merits further study.
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页数:9
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