Global biomarkers of oxidative stress and fractures: a matched case-control study

Shuman Yang; Lijie Feng; Lisa M Lix; William D Leslie; Dingjie Guo; Xianbao Shi; Baoming Yuan

doi:10.3389/fendo.2023.1179521

Global biomarkers of oxidative stress and fractures: a matched case-control study

Front Endocrinol (Lausanne). 2023 Jun 23:14:1179521. doi: 10.3389/fendo.2023.1179521. eCollection 2023.

Authors

Shuman Yang^{1

2}, Lijie Feng¹, Lisa M Lix³, William D Leslie⁴, Dingjie Guo¹, Xianbao Shi⁵, Baoming Yuan⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
² Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China.
³ Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁴ Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
⁵ Department of Pharmacy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China.
⁶ Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China.

Abstract

Background: Evidence for a relationship between oxidative stress and osteoporotic fractures in humans is limited. Fluorescent oxidation products (FlOPs, excitation/emission wavelengths 320/420nm denoted FlOP_320; 360/420nm [FlOP_360]; and 400/475nm [FlOP_400]) are global biomarkers of oxidative stress, and reflect oxidative damage to proteins, phospholipids, and nucleic acids. We investigated the association between FlOPs and a recent osteoporotic fracture.

Methods: We conducted a case-control study in a Chinese population aged 50 years or older. A recent osteoporotic fracture in the cases was confirmed by x-ray. Cases were matched with community-based non-fracture controls (1:2 ratio) for age (± 4 years) and sex. In addition, we conducted a sensitivity unmatched case-control study which included all fracture cases and all eligible non-fracture controls prior to matching. Plasma FlOPs were measured with a fluorescent microplate reader. We used unconditional logistic regression to analyze the association between FlOPs (per 1-SD increase in logarithmic scale) and fracture; odds ratios (OR) and 95% confidence intervals (95% CI) were reported.

Results: Forty-four cases and 88 matched controls (mean age: 68.2 years) were included. After covariate adjustment (i.e., body mass index, physical activity, and smoking), higher FlOP_360 (OR = 1.85; 95% CI = 1.03 - 3.34) and FlOP_400 (OR = 13.29; 95% CI = 3.48 - 50.69) levels, but not FlOP_320 (OR = 0.56; 95% CI = 0.27 - 1.15), were associated with increased fracture risk. Subgroup analyses by fracture site and unmatched case-control study found comparable associations of FlOP_360 and FlOP_400 with hip and non-hip fractures.

Conclusions: Higher FlOP_360 and FlOP_400 levels were associated with increased risk of fracture, and this association was comparable for hip and non-hip fractures. Prospective studies are warranted to confirm this finding.

Keywords: Chinese; case-control study; fluorescent oxidation products; fracture; hip fractures; non-hip fractures; osteoporosis; oxidative stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomarkers
Case-Control Studies
Hip Fractures* / epidemiology
Humans
Osteoporotic Fractures* / epidemiology
Osteoporotic Fractures* / etiology
Oxidative Stress

Substances

Biomarkers

Grants and funding

This work was supported by research grants from the Changchun Scientific and Technological Development Program (Grant Numbers: 21ZGM28; 21ZGM27). This research was also partly supported by the Norman Bethune Program, Jilin University (Grant Number: 2023B11).