TY  - JOUR
A1  - Haring, Bernhard
A1  - Crandall, Carolyn J
A1  - Carbone, Laura
A1  - Liu, Simin
A1  - Li, Wenjun
A1  - Johnson, Karen C
A1  - Wactawski-Wende, Jean
A1  - Shadyab, Aladdin H
A1  - Gass, Margery L
A1  - Kamensky, Victor
A1  - Cauley, Jane A
A1  - Wassertheil-Smoller, Sylvia
T1  - Lipoprotein(a) plasma levels, bone mineral density and risk of hip fracture: a post hoc analysis of the Women’s Health Initiative, USA
JF  - BMJ Open
N2  - Objectives 
Elevated Lipoprotein(a) (Lp[a]) is a well-known risk factor for cardiovascular disease. However, its roles in bone metabolism and fracture risk are unclear. We therefore investigated whether plasma Lp(a) levels were associated with bone mineral density (BMD) and incident hip fractures in a large cohort of postmenopausal women.

Design 
Post hoc analysis of data from the Women’s Health Initiative (WHI), USA.

Setting 
40 clinical centres in the USA.

Participants 
The current analytical cohort consisted of 9698 white, postmenopausal women enrolled in the WHI, a national prospective study investigating determinants of chronic diseases including heart disease, breast and colorectal cancers and osteoporotic fractures among postmenopausal women. Recruitment for WHI took place from 1 October 1993 to 31 December 1998.

Exposures 
Plasma Lp(a) levels were measured at baseline.

Outcome measures 
Incident hip fractures were ascertained annually and confirmed by medical records with follow-up through 29 August 2014. BMD at the femoral neck was measured by dual X-ray absorptiometry in a subset of participants at baseline.

Statistical analyses 
Cox proportional hazards and logistic regression models were used to evaluate associations of quartiles of plasma Lp(a) levels with hip fracture events and hip BMD T-score, respectively.

Results 
During a mean follow-up of 13.8 years, 454 incident cases of hip fracture were observed. In analyses adjusting for confounding variables including age, body mass index, history of hysterectomy, smoking, physical activity, diabetes mellitus, general health status, cardiovascular disease, use of menopausal hormone therapy, use of bisphosphonates, calcitonin or selective-oestrogen receptor modulators, baseline dietary and supplemental calcium and vitamin D intake and history of fracture, no significant association of plasma Lp(a) levels with low hip BMD T-score or hip fracture risk was detected.

Conclusions 
These findings suggest that plasma Lp(a) levels are not related to hip BMD T-score or hip fracture events in postmenopausal women.
KW  - hip fracture
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201139
VL  - 9
ER  -