Osteoporosis is a major public health problem in men and women. Low bone mineral density (BMD) is a major risk factor for fracture. Fractures have major implications for morbidity and mortality. This research project evaluated correlates of trabecular and cortical vBMD at the radius and tibia in primarily Caucasian men aged 69 years or older using the Osteoporotic Fractures in Men study (MrOS). The correlation between serum 25-hydroxy vitamin D [25(OH)D] and bone density, content, geometry and strength was also assessed using Caucasian men from MrOS and men of African descent from the Tobago Bone Health Study, aged 65 years and older. We also investigated the longitudinal impact of serum leptin and adiponectin on bone loss and fractures in the Health Aging and Body Composition study (Health ABC) in men and women, aged 70 years and older, of African American and Caucasian descent. Our findings have important public health implications. We have a better understanding of how different factors are correlated with trabecular and cortical and vBMD. Future research can generate hypotheses to evaluate these associations prospectively. Men of African descent had significantly higher 25(OH)D than Caucasians, which has never been reported. Serum 25(OH)D was positively correlated with indices of bone strength in Caucasian men, but not men of African descent. Serum 25(OH)D thresholds were identified at an estimated 20 ng/ml (lower than previous consensus of 30 ng/ml), greater levels of 25(OH)D had minimal effects on bone measures. Significant correlations between 25(OH)D occurred only at cortical regions. Prospective studies that evaluate the impact of 25(OH)D on trabecular and cortical vBMD loss are needed. There was an association between higher adiponectin and greater risk of incident fracture in men only. We also report that adiponectin predicted greater hip areal BMD (aBMD) loss among women, but not men. The impact of leptin on bone loss and incident fractures was largely attenuated by BMI and weight change. This study provides strong evidence that higher levels of adiponectin may increase the risk of bone loss and fracture. Studies are needed to explain these differential associations for adiponectin in women and men.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04082010-183309 |
| Date | 28 June 2010 |
| Creators | Barbour, Kamil Elie |
| Contributors | Jane Cauley, Mara Horwitz, Rhobert Evans, Joseph Zmuda, Robert Boudreau, Elsa Strotmeyer |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04082010-183309/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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