Research: MICHAËLSSON and COLLEAGUES,

Listed in Issue 237

Abstract

MICHAËLSSON and COLLEAGUES,  (1)Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden (KM and LB); the Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (AW); the School of Health and Social Studies, Dalarna University, Falun, Sweden (JÄ); the Department of Public  Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden (JÄ); and the Department of Medical Sciences, Clinical Pharmacology, Uppsala University, Uppsala, Sweden (HM) conducted two cohort studies to determine whether α-tocopherol intake or serum concentrations are associated with fracture risk in older women and men.

Background

A reduction in the formation of free radicals and oxidative stress might reduce the rate of bone loss and muscle wasting.

Methodology

The objective was to determine whether α-tocopherol intake or serum concentrations are associated with fracture risk in older women and men. Two cohort studies, the Swedish Mammography Cohort (SMC; n = 61,433 women) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n = 1138 men), were used.

Results

During 19 y of follow-up, 14,738 women in the SMC experienced a first fracture at any site (3871 hip fractures). A higher hip fracture rate was observed with lower intakes of α-tocopherol. Compared with the highest quintile of intake, the lowest quintile had a multivariable-adjusted Hazard Radio (HR) of 1.86 (95% CI: 1.67, 2.06). The HR of any fracture was 1.20 (95% CI: 1.14, 1.28). α-Tocopherol-containing supplement use was associated with a reduced rate of hip fracture (HR: 0.78; 95% CI: 0.65, 0.93) and any fracture (HR: 0.86; 95% CI: 0.78, 0.94). Compared with the highest quintile of α-tocopherol intake in ULSAM (follow-up: 12 y), lower intakes (quintiles 1-4) were associated with a higher rate of hip fracture (HR: 3.33; 95% CI: 1.43, 7.76) and any fracture (HR: 1.84; 95% CI: 1.18, 2.88). The HR for hip fracture in men for each 1-SD decrease in serum α-tocopherol was 1.58 (95% CI: 1.13, 2.22) and for any fracture was 1.23 (95% CI: 1.02, 1.48).

Conclusion

Low intakes and low serum concentrations of α-tocopherol are associated with an increased rate of fracture in elderly women and men.

References

Michaëlsson K(1), Wolk A, Byberg L, Ärnlöv J, Melhus H. Intake and serum concentrations of α-tocopherol in relation to fractures in elderly women and men: 2 cohort studies. Am J Clin Nutr. 99(1):107-14. Jan 2014. doi: 10.3945/ajcn.113.064691. Epub 2013 Nov 13.

Comment

The above results indicate that higher intakes of α-tocopherol for both men and women are directly correlated with lower hip fracture hazard ratio - HR; it is hoped that these results will be translated into clinical practice.

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