Relationships between markers of inflammation and bone density:
findings from the Hertfordshire Cohort Study
N. R. Fuggle
L. D. Westbury
H. E. Syddall
N. A. Duggal
S. C. Shaw
E. M. Dennison
International Osteoporosis Foundation and National Osteoporosis Foundation 2018
Summary Among 365 Hertfordshire Cohort Study participants (aged 59–71 years at baseline), higher adiponectin and
adiponectin to leptin ratios were associated with lower baseline lumbar spine and femoral neck bone mineral density (BMD).
Lower IL-10 was associated with accelerated decline in lumbar spine BMD. This suggests that bone health can be influenced by
changes in immune phenotype and alterations in adipokine homeostasis.
Introduction The aim of this study was to examine the association between indices of inflammation and BMD in a population-
based cohort of older adults in the UK.
Methods Analyses were based on a sample of 194 men and 171 women of the Hertfordshire Cohort Study (community-living,
older adults). Dual energy X-ray absorptiometry (DXA) was performed at the lumbar spine and proximal femur at baseline and
repeated at a median of 4.5 years (inter-quartile range 3.6 to 5.2). Inflammatory markers (CRP, TNF, IL-1β, IL-6, IL-8, IL-10,
adiponectin and leptin) were ascertained at baseline using enzyme-linked immunosorbent assay (ELISA) techniques and Bio-
Plex Pro Assays. Gender-adjusted linear regression was used to examine the associations between markers of inflammation and
outcomes with and without adjustment for anthropometric and lifestyle factors.
Results The mean (SD) ages at baseline were 64.4 (2.5) and 66.5 (2.7) years for men and women respectively. Higher levels of
adiponectin and adiponectin to leptin ratios were each associated with lower baseline lumbar spine and femoral neck BMD in
gender-adjusted (p < 0.01) and fully adjusted (p < 0.05) analyses. Lower levels of IL-10 and TNF were each associated with
accelerated decline in lumbar spine BMD in both gender-adjusted (p ≤ 0.05) and fully adjusted (p < 0.05) analyses.
Conclusions In a cohort of older adults, high levels of adiponectin and adiponectin to leptin ratios were both associated with
lower BMD at the lumbar spine and femoral neck at baseline, and lower IL-10 was associated with accelerated decline in BMD at
the lumbar spine. This adds weight to the theory that bone health can be influenced by changes in immune phenotype and
alterations in adipokine homeostasis.
Bone mineral density
* C. Cooper
MRC Lifecourse Epidemiology Unit, University of Southampton,
Tremona Road, Southampton SO16 6YD, UK
MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute
of Inflammation and Ageing, University of Birmingham,
NIHR Birmingham Biomedical Research Centre in Inflammation,
University Hospital Birmingham, Birmingham, UK
Victoria University of Wellington, Wellington, New Zealand
NIHR Southampton Biomedical Research Centre, University of
Southampton and University Hospital Southampton NHS Foundation
Trust, Southampton, UK
NIHR Musculoskeletal Biomedical Research Unit, University of
Oxford, Oxford, UK