Vertebral Fractures: Inflammation, hsCRP association in Men Interview with: Anna Eriksson MD, PhD
Centre for Bone and Arthritis Research
Institute of Medicine, Sahlgrenska University Hospital,
Gothenburg, Sweden What are the main findings of the study?

Answer: The main findings of the study are that low-grade inflammation as measured by high sensitive CRP (hsCRP) is a risk factor for fractures in men, and that this is mainly driven by an increased risk for vertebral fractures. Previous epidemiological research has shown that higher levels of hsCRP is associated with an increased risk for fractures in women but until now it has not been known whether this applies also to men. The associations between hsCRP and fracture risk remained also after controlling for a wide range of known risk factors for fractures. There were no associations between hsCRP and BMD in our study. This implies that low-grade inflammation is an independent risk factor for fractures. Were any of the findings unexpected?

Answer: Given the previous findings in women, the association between hsCRP levels and fracture risk also in men was not unexpected. However, previous studies have not had the power to discriminate between different types of fractures, hence the fact that vertebral fractures was the fracture type mainly associated with hsCRP was unexpected to us and the result of exploratory sub analyses. What should clinicians and patients take away from your report?

Answer: Low grade inflammation is an independent risk factor for fractures in men. This could be kept in mind when the fracture risk is assessed in a patient. What recommendations do you have for future research as a result of this study?

Answer: It would be interesting to more thoroughly study the magnitude of the fracture increase at different levels of hsCRP in different populations. Perhaps hsCRP could be included in the FRAX fracture risk assessment tool in the future. It would also be interesting to study more inflammation markers and also bone structure, to understand more about potential causal mechanisms underlying the increased fracture risk.


High sensitive CRP is an independent risk factor for all fractures and vertebral fractures in elderly men: The MrOS Sweden study

Eriksson AL, Movérare-Skrtic S, Ljunggren O, Karlsson M, Mellström D, Ohlsson C.

Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

J Bone Miner Res. 2013 Jul 15.
doi: 10.1002/jbmr.2037.
[Epub ahead of print]