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Title: Plasma phosphatidylcholine concentrations of polyunsaturated fatty acids are differentially associated with hop bone mineral density and hip fracture in older adults: The Framingham Osteoporosis Study

Author
item FARINA, EMILY K. - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item KIEL, DOUGLAS P. - Hebrew Seniorlife Research
item ROUBENOFF, RONENN - Tufts University
item SCHAEFER, ERNST J. - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item CUPPLES, L. ADRIENNE - Boston University
item TUCKER, KATHERINE L. - Northeastern University

Submitted to: Journal of Bone and Mineral Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/30/2012
Publication Date: 5/1/2012
Citation: Farina, E., Kiel, D., Roubenoff, R., Schaefer, E., Cupples, L., Tucker, K. 2012. Plasma phosphatidylcholine concentrations of polyunsaturated fatty acids are differentially associated with hop bone mineral density and hip fracture in older adults: The Framingham Osteoporosis Study. Journal of Bone and Mineral Research. 27(5):1222-1230.

Interpretive Summary: Loss of bone is a major problem in the elderly population. We have worked with over 500 elderly people who are being followed in the Framingham Heart Study for bone loss as assessed by examinations of bone density. We have measured the levels of fatty acids in the blood phospholipid fraction phosphatidylcholice (PC). This analysis serves as a good measure of the type of fat that people eat over time. One of the fats found in this fraction is called docosahexaenoic acid or DHA, mainly found in oily fish or fish oil capsules. High levels of PC DHA linked to increased fish intake were found to inhibit of bone loss in men, but were associated with bone loss in women. This was a surprising finding, and the data indicates that dietary predictors of bone loss may be different in men and women. Our results show that high fish intake (greater than 3 fish meals per week) may not be ideal in women who suffer from osteoporosis. This research is of interest to people who are trying to prevent bone loss and fractures associated with aging.

Technical Abstract: Polyunsaturated fatty acids (PUFA) may influence bone health. Our objective was to examine associations between plasma phosphatidylcholine (PC) PUFA concentrations and hip measures: 1) femoral neck bone mineral density (FN-BMD) (n=765); 2) 4-y change in FN-BMD (n=556); and 3) hip fracture risk (n=765) over 17-y follow-up among older adults in the Framingham Osteoporosis Study. BMD measures were regressed on quintile of plasma PC PUFA (docosahexaenoic acid (DHA), linoleic acid (LA), and arachidonic acid (AA)), adjusted for covariates. Hazard ratios (HR) and 95% CI for hip fracture were estimated by quintile of plasma PC PUFA, adjusted for covariates. We found that higher concentrations of PC DHA were associated with loss of FN-BMD over 4-y in women (P-trend=0.04), but was protective in men in the upper-most quintile compared to men grouped in the lower four quintiles, in post-hoc analysis (P=0.01). PC LA concentrations were inversely associated with baseline FN-BMD in women (P-trend=0.02), and increased hip fracture risk in women and men (P-trend=0.05), but BMI adjustment attenuated these associations (P-trend=0.12 and P-trend=0.14, respectively). A trend toward a protective association was observed between PC AA and baseline FN-BMD in men (P-trend=0.06). Women and men with the highest PC AA concentrations had 51% lower hip fracture risk than those with the lowest (HR=0.49, 95% CI=0.24 to 1.00). In conclusion opposing effects of PC DHA on FN-BMD loss were observed in women and men, and this requires further clarification. Bone loss associated with PC LA may be confounded by BMI. High PC AA concentrations may be associated with reduced hip fracture risk.