Association of Serum Phosphate, Calcium and Alkaline Phosphatase With Risk of Incident Fractures in Healthy Older Adults.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: United States NLM ID: 0375362 Publication Model: Print Cited Medium: Internet ISSN: 1945-7197 (Electronic) Linking ISSN: 0021972X NLM ISO Abbreviation: J Clin Endocrinol Metab Subsets: MEDLINE
    • Publication Information:
      Publication: 2017- : New York : Oxford University Press
      Original Publication: Springfield, Ill. : Charles C. Thomas
    • Subject Terms:
      Alkaline Phosphatase*/blood ; Phosphates*/blood ; Calcium*/blood ; Fractures, Bone*/epidemiology ; Fractures, Bone*/blood ; Fractures, Bone*/etiology; Humans ; Male ; Female ; Aged ; Aged, 80 and over ; Incidence ; Australia/epidemiology ; Risk Factors ; United States/epidemiology ; Biomarkers/blood
    • Abstract:
      Context: Aging increases fracture risk through bone loss and microarchitecture deterioration due to an age-related imbalance in bone resorption and formation during bone remodeling.
      Objective: We examined the associations between levels of phosphate, calcium (Ca), and alkaline phosphatase (ALP), and fracture risk in initially healthy older individuals.
      Methods: A post hoc analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial recruited 16 703 Australian participants aged 70 years and older and 2411 US participants aged 65 years and older. Analyses were conducted on ASPREE-Fracture substudy participants from Australia with serum calcium, phosphate, and ALP measurement. Fracture data were collected post randomization. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs. Phosphate, Ca, and ALP were analyzed in deciles (D1-D10), with deciles 4 to 7 (31%-70%) as the reference category. Restricted cubic spline curves were used to identify nonlinear associations.
      Results: Of the 9915 participants, 907 (9.2%) individuals had incident fractures recorded over 3.9 (SD 1.4) years. In the fully adjusted model, men in the top decile (D10) of phosphate had a 78% higher risk of incident fracture (HR 1.78; 95% CI, 1.25-2.54). No such association was observed for women (HR 1.09; 95% CI, 0.83-1.44). The population attributable fraction in men within the D10 phosphate category is 6.9%.
      Conclusion: This result confirms that high-normal serum phosphate levels are associated with increased fracture risk in older men.
      (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
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    • Grant Information:
      U01 AG029824 United States AG NIA NIH HHS; U01AG029824 United States NH NIH HHS; Victorian Cancer Agency; 334037 National Health and Medical Research Council; the NIH; Monash University; National Institute on Aging and the National Cancer Institute
    • Contributed Indexing:
      Keywords: alkaline phosphatase; calcium; fractures; older individuals; phosphate
    • Accession Number:
      EC 3.1.3.1 (Alkaline Phosphatase)
      0 (Phosphates)
      SY7Q814VUP (Calcium)
      0 (Biomarkers)
    • Publication Date:
      Date Created: 20240301 Date Completed: 20241117 Latest Revision: 20241120
    • Publication Date:
      20241120
    • Accession Number:
      PMC11570385
    • Accession Number:
      10.1210/clinem/dgae099
    • Accession Number:
      38426788