High-Sensitivity C-Reactive Protein and Risk of Nontraumatic Fractures
As a way of background, an odds ratio gives you an idea of whether an intervention or condition increases or decreases risk of a disease. OR of 1 means no effect, less then 1 protects, more then 1 increases. So an OR of 2 means doubling of risk. With this as background, consider osteoporosis.
It is pretty much a lock that inflammation is a major player in bone loss. Higher levels of TNF-alpha, a mediator of inflammation, will end up producing greater numbers of osteoclasts–the cells that break down bone. So, more inflammation = more osteoclasts = more bone loss. But this association seems to have escaped the standard of care for osteopenia or osteoporosis. I just have never had a patient come in that was counseled in anything other then antiresorptive agents like Fosomax and maybe some extra calcium.
Back to this study. In the Archives of Internal Medicine, a relatively high level journal, we see that comparing the lowest levels of hs CRP (a lab marker of inflammation) to the highest level produced an OR of 9.3. That’s a staggering 9 X risk for osteoporosis of an already high risk disease. This makes inflammation the major player in bone loss. And yet it is ignored when it comes to prevention and treatment. Inexcusable.