Bone Metabolism Analytes as Biomarkers of Pre-Frailty and Cardiovascular Disease Risk in Females

Abstract

Background: Frailty and cardiovascular disease (CVD) share common pathophysiology in their progression. Declines in bone health often occur concomitantly with frailty and CVD. Therefore, analytes of bone metabolism may be useful biomarkers of pre-frailty and CVD risk. The aim of this study was to identify the effects of pre-frailty and CVD risk on the systemic concentrations of bone metabolism and inflammatory analytes in middle-aged and older females. Method: This case-control study is a secondary analysis of data from 1030 females with no self-reported history of CVD. Frailty was measured using the Fried Criteria, and females were stratified into low and elevated CVD risk using the Framingham risk score. Greedy matching with pre-frailty as the exposure variable identified 26 matched pairs in the low and elevated CVD risk groups for a total of 104 females. Factorial ANOVA compared differences in the log transformed concentrations of 15 bone metabolism analytes based on pre-frailty status, CVD risk, and the interaction. Results: Differences in the systemic concentrations of IL-6 (5.25 ± 14.30 vs 1.35 ± 1.74 pg/mL, p = 0.001), TNFα (1.41 ± 1.83 vs 0.89 ± 0.40 pg/mL, p = 0.06), and leptin (12628.48 ± 10472.90 vs 7562.96 ± 4972.25 pg/mL, p = 0.023) were found in elevated CVD risk status compared to low. No differences in the concentrations of bone metabolism analytes were found based on pre-frailty status, nor were any interaction effects. Conclusion: Differences were found in the concentrations of cytokines involved in bone metabolism based on CVD risk; however, no differences were found based on pre-frailty status. IL-6, TNFα, and leptin may act as biomarkers of CVD risk, but this study does not support the use of the examined analytes involved in bone metabolism as biomarkers of pre-frailty.