Older men with low serum IGF-1 have an increased risk of incident fractures: The MrOS Sweden study

Claes Ohlsson, Dan Mellström, Daniel Carlzon, Eric Orwoll, Östen Ljunggren, Magnus K. Karlsson, Liesbeth Vandenput

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Insulin-like growth factor 1 (IGF-1) is a key determinant of bone mass, but the association between serum IGF-1 and incident fractures in men remains unclear. To determine the predictive value of serum IGF-1 for fracture risk in men, older men (n=2902, mean age of 75 years) participating in the prospective, population-based Osteoporotic Fractures in Men (MrOS) Sweden study were followed for a mean of 3.3 years. Serum IGF-1 was measured at baseline by radioimmunoassay. Fractures occurring after the baseline visit were validated. In age-adjusted hazards regression analyses, serum IGF-1 associated inversely with risk of all fractures [hazard ratio (HR) per SD decrease=1.23, 95% confidence interval (CI) 1.07-1.41], hip fractures (HR per SD decrease=1.45, 95% CI 1.07-1.97), and clinical vertebral fractures (HR per SD decrease=1.40, 95% CI 1.10-1-78). The predictive role of serum IGF-1 for fracture risk was unaffected by adjustment for height, weight, prevalent fractures, falls, and major prevalent diseases. Further adjustment for bone mineral density (BMD) resulted in an attenuated but still significant association between serum IGF-1 and fracture risk. Serum IGF-1 below but not above the median was inversely related to fracture incidence. The population-attributable risk proportion was 7.5% for all fractures and 22.9% for hip fractures. Taken together, older men with low serum IGF-1 have an increased fracture risk, especially for the two most important fracture types, hip and vertebral fractures. The association between serum IGF-1 and fracture risk is partly mediated via BMD.

Original languageEnglish (US)
Pages (from-to)865-872
Number of pages8
JournalJournal of Bone and Mineral Research
Volume26
Issue number4
DOIs
StatePublished - Apr 1 2011

Keywords

  • Population studies
  • aging
  • fracture
  • insulin-like growth factor 1
  • men

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

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    Ohlsson, C., Mellström, D., Carlzon, D., Orwoll, E., Ljunggren, Ö., Karlsson, M. K., & Vandenput, L. (2011). Older men with low serum IGF-1 have an increased risk of incident fractures: The MrOS Sweden study. Journal of Bone and Mineral Research, 26(4), 865-872. https://doi.org/10.1002/jbmr.281