The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Osteoporosis International Pub Date : 2025-02-21 DOI:10.1007/s00198-025-07428-x

Lu Guo, Nan Zhang, Xinhao Fan, Xiaoli Hou, Man Li, Wenqi Xu, Peipei Liu, Lei Xing, Jingyao Wang, Shuohua Chen, Shouling Wu, Faming Tian

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引用次数: 0

Abstract

This study explored the association between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in Chinese males. Results show that elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.

Purpose: This study investigates the relationship between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in a Chinese male population.

Methods: A total of 48,186 male participants (age range 18-98 years old, average age 53.92 years) at baseline were recruited from the Kailuan Study and followed up for outcomes until 2022. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident fragility fractures. The dose response between CAR and fracture risk was analyzed using restricted cubic splines. Additionally, the concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI) were utilized to assess the incremental predictive value of various indicators for the discrimination of fragility fractures.

Results: During an average follow-up of 11.17 years, 728 incident fragility fractures occurred among the 48,186 participants. Compared to participants in the second quartile of CAR, those in the highest quartile had a 49% increased risk of fragility fractures (HR = 1.49, 95% CI = 1.21-1.84) after adjusting for risk factors. Restricted cubic spline analysis showed a nonlinear relationship between CAR and the risk of fragility fractures. The C-index, continuous NRI, and IDI for predicting the risk of fragility fractures were 61.142%, 0.089 (p < 0.05), and 0.00009 (p < 0.05), respectively, which were higher than those of hs-CRP (C-index 0.6137, NRI 0.086, IDI 0.000074) and albumin (C- index 0.6116, NRI 0.068, IDI - 0.000004).

Conclusion: Elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.

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超敏c反应蛋白/白蛋白比对中国男性脆性骨折风险的影响。

本研究探讨了中国男性超敏c反应蛋白与白蛋白比（CAR）与脆性骨折之间的关系。结果表明，CAR水平升高与脆性骨折的风险增加有关，并且这种关联对于多种潜在混杂因素的调整是稳健的。目的：探讨中国男性脆性骨折与超敏c反应蛋白/白蛋白比（CAR）的关系。方法：从开滦研究中招募基线时48186名男性参与者（年龄18-98岁，平均年龄53.92岁），随访至2022年。采用Cox比例风险模型计算易碎性骨折的风险比（hr）和95%置信区间（ci）。用限制三次样条分析了CAR与骨折风险之间的剂量反应。此外，利用一致性指数（C-index）、净重分类指数（NRI）和综合判别改进（IDI）来评估各指标对脆性骨折判别的增量预测价值。结果：在平均11.17年的随访期间，48186名参与者中发生了728例易碎性骨折。与CAR第二四分位数的参与者相比，在调整危险因素后，最高四分位数的参与者脆性骨折的风险增加了49% （HR = 1.49, 95% CI = 1.21-1.84）。限制三次样条分析表明，CAR与脆性骨折风险之间存在非线性关系。预测脆性骨折风险的c指数、连续NRI和IDI分别为61.142%、0.089 (p)。结论：CAR水平升高与脆性骨折风险增加相关，并且这种关联对于多种潜在混杂因素的调整是稳定的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.