@article {9087, title = {The Association of Lipids and Lipoproteins with Hip Fracture Risk the Cardiovascular Health Study.}, journal = {Am J Med}, year = {2022}, month = {2022 Jun 06}, abstract = {

BACKGROUND: It is uncertain if lipids or lipoproteins are associated with osteoporotic fractures. In this study, incident hip fracture risk according to conventional lipid levels and lipoprotein levels and sizes was examined.

METHODS: We followed 5832 participants aged >=65 years from the Cardiovascular Health Study for hip fracture for a mean of 13.5 (SD 5.7) years. Standard enzymatic methods were used to determine lipid levels (HDL-c, LDL-c, triglycerides). Nuclear magnetic resonance spectroscopy was used to measure lipoprotein fractions (VLDL-P, LDL-P, HDL-P) in a subset of 1849 participants.

RESULTS: We documented 755 incident hip fractures among women (1.19 fractures per 100 participant years [95\% CI, 1.04, 1.35]) and 197 among men (0.67 fractures per 100 participant years [95\% CI, 0.41, 1.10]) over an average follow-up. HDL-c and LDL-c levels had statistically significant non-linear U-shaped relationships with hip fracture risk (HDL-c, p=0.009; LDL-c, p=0.02). Triglyceride levels were not significantly associated with hip fracture risk. In fully adjusted conjoint models, higher VLDL-P concentration [HR per 1-standard (SD) increment 1.47 (1.13, 1.91)] and size [HR per 1-SD increment 1.24 [1.05, 1.46]) and higher HDL-P size (HR per 1-SD increment 1.81 [1.25, 2.62]) were all associated with higher hip fracture risk.

CONCLUSIONS: Lipids and lipoproteins are associated with hip fracture risk in older adults. The associations are complex. Mechanistic studies are needed to understand these findings.

}, issn = {1555-7162}, doi = {10.1016/j.amjmed.2022.05.024}, author = {Barzilay, Joshua I and B{\r u}zkov{\'a}, Petra and Kuller, Lewis H and Cauley, Jane A and Fink, Howard A and Sheets, Kerry and Robbins, John A and Carbone, Laura D and Elam, Rachel E and Mukamal, Kenneth J} }