Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study
Am J Clin Nutr May 2015 vol. 101 no. 5 947-955
Tamara B Harris, Xiaoling Song, Ilse Reinders, Thomas F Lang, Melissa E Garcia, Kristin Siggeirsdottir, Sigurdur Sigurdsson, Vilmundur Gudnason, Gudny Eiriksdottir, Gunnar Sigurdsson, Laufey Steingrimsdottir, Thor Aspelund, Ingeborg A Brouwer, and Rachel A Murphy rachel.murphy at nih.gov
From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
Supported by The Office of Dietary Supplements, NIH contract N01-AG012100, the NIA Intramural Research Program, Hjartavernd (the Icelandic Heart Association), the Althingi (the Icelandic Parliament), and a Banting Postdoctoral Fellowship (to RAM).
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Background: Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake.
Objective: We aimed to examine associations between fatty acids measured in late life and fish-oil consumption in early life, midlife, and late life with osteoporotic fracture risk.
Design: Osteoporotic fractures were determined from medical records over 5–9 y of follow-up in men and women aged 66–96 y. Data were analyzed from 1438 participants including 898 participants who were randomly selected from the Age, Gene/Environment Susceptibility Study, which is an observational study, and 540 participants with incident fracture. Plasma phospholipid fatty acids were assessed by using gas chromatography. Fish-oil consumption was assessed by using validated questionnaires as never (referent), less than daily, or daily. HRs and 95% CIs adjusted for age, education, height, weight, diabetes, physical activity, and medications were estimated by using Cox regression.
Results: In men, the highest tertile of PUFAs, n–3 (ω-3), and eicosapentaenoic acid were associated with decreased fracture risk [HRs (95% CIs): 0.60 (95% CI: 0.41, 0.89), 0.66 (0.45, 0.95), and 0.59 (0.41, 0.86), respectively]. In women, PUFAs tended to be inversely associated with fracture risk (P-trend = 0.06), but tertiles 2 and 3 were not independently associated with risk. Tertile 2 of n–6 and arachidonic acid was associated with fracture risk in women [HRs (95% CIs): 1.43 (1.10, 1.85) and 1.42 (1.09, 1.85), respectively].
Daily fish-oil consumption in late life was associated with lower fracture risk in men (HR: 0.64; 95% CI: 0.45, 0.91).
Daily fish-oil consumption in midlife was associated with lower fracture risk in women (HR: 0.75; 95% CI: 0.58, 0.98).
Conclusions: Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults, particularly in men. Critical time periods for n–3 fatty acid consumption may differ by sex.