Genetic Prediction of Lifetime Risk of Fracture

医学 内科学 股骨颈 髋部骨折 骨质疏松症 人口学 骨矿物 人口 背景(考古学) 前瞻性队列研究 风险评估 单核苷酸多态性 多基因风险评分 老年学 基因型 环境卫生 生物 遗传学 社会学 古生物学 基因 计算机科学 计算机安全
作者
Thao P. Ho-Le,Thach Tran,Huy G. Nguyen,Jacqueline R. Center,John A. Eisman,Tuan V. Nguyen
出处
期刊:The Journal of Clinical Endocrinology and Metabolism [Oxford University Press]
卷期号:108 (11): e1403-e1412 被引量:5
标识
DOI:10.1210/clinem/dgad254
摘要

Abstract Context Fragility fracture is a significant public health problem because it is associated with increased mortality. We want to find out whether the risk of fracture can be predicted from the time of birth. Objective To examine the association between a polygenic risk score (PRS) and lifetime fracture risk. Methods This population-based prospective study involved 3515 community-dwelling individuals aged 60+ years who have been followed for up to 20 years. Femoral neck bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry. A PRS was created by summing the weighted number of risk alleles for each single nucleotide polymorphism using BMD-associated coefficients. Fragility fractures were radiologically ascertained, whereas mortality was ascertained through a state registry. Residual lifetime risk of fracture (RLRF) was estimated by survival analysis. Results The mortality-adjusted RLRF for women and men was 36% (95% CI, 34%-39%) and 21% (18%-24%), respectively. Individuals with PRS > 4.24 (median) had a greater risk (1.2-fold in women and 1.1-fold in men) than the population average risk. For hip fracture, the average RLRF was 10% (95% CI, 8%-12%) for women and ∼5% (3%-7%) for men; however, the risk was significantly increased by 1.5-fold and 1.3-fold for women and men with high PRS, respectively. Conclusion A genetic profiling of BMD-associated genetic variants is associated with the residual lifetime risk of fracture, suggesting the potential for incorporating the polygenic risk score in personalized fracture risk assessment.
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