Lipids, lipoproteins linked to hip fracture risk

In older adults, lipids and lipoproteins play a major role in the risk of hip fracture, reveals a study, noting that such associations are complex.

The authors followed 5,832 participants aged ≥65 years from the Cardiovascular Health Study for hip fracture for a mean of 13.5 years. They determined lipid levels (ie, high- [HDL-C] and low-density lipoprotein cholesterol [LDL-C] and triglycerides) using standard enzymatic methods.

In a subset of 1,849 participants, the authors used nuclear magnetic resonance spectroscopy to measure lipoprotein fractions (ie, very-low [VLDL-P], low- [LDL-P], and high-density lipoprotein particle (HDL-P]).

During follow-up, 755 incident hip fractures were reported among women (1.19 fractures per 100 participant-years, 95 percent confidence interval [CI], 1.04‒1.35) and 197 among men (0.67 fractures per 100 participant-years, 95 percent CI, 0.41‒1.10).

Statistically significant nonlinear U-shaped associations were observed between levels of HDL-C (p=0.009) and LDL-C (p=0.02) and risk of hip fracture, while triglyceride levels showed no significant relationship with said risk.

Fully adjusted conjoint models showed the association of higher VLDL-P concentration (hazard ratio [HR] per 1 standard deviation [SD] increment, 1.47, 95 percent CI, 1.13‒1.91) and size (HR per 1 SD increment, 1.24, 95 percent CI, 1.05‒1.46) and higher HDL-P size (HR per 1 SD increment, 1.81, 95 percent CI, 1.25‒2.62) with higher hip fracture risk.

“Mechanistic studies are needed to understand these findings,” the authors said.