Triglyceride levels and fracture risk in midlife women: Study of women's health across the nation (SWAN)

Po Yin Chang, Ellen B Gold, Jane A. Cauley, Wesley O. Johnson, Carrie Karvonen-Gutierrez, Elizabeth A. Jackson, Kristine M. Ruppert, Jennifer S. Lee

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Context: Unfavorable lipid levels contribute to cardiovascular disease and may also harm bone health. Objective: Our objective was to investigate relationships between fasting plasma lipid levels and incident fracture in midlife women undergoing the menopausal transition. Design and Setting: This was a 13-year prospective, longitudinal study of multiethnicwomenin five US communities, with near-annual assessments. Participants: At baseline, 2062 premenopausal or early perimenopausalwomenwhohadnohistory of fracture were included. Exposures: Fasting plasma total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol at baseline and follow-up visits 1 and 3-7. Main Outcome Measure(s): Incident nontraumatic fractures 1) 2 or more years after baseline, in relation to a single baseline level of lipids; and 2) 2-5 years later, in relation to time-varying lipid levels. Cox proportional hazards modelings estimated hazard ratios and 95% confidence interval (CI). Results:Amongthe lipids, TG levels changed the most, with median levels increased by16%during follow-up. An increase of 50 mg/dl in baseline TG level was associated with a 1.1-fold increased hazards of fracture (adjusted hazard ratio, 1.11; 95% CI, 1.04-1.18). Women with baseline TG higher than 300 mg/dl had an adjusted 2.5-fold greater hazards for fractures (95% CI, 1.13-5.44) than women with baseline TG lower than 150 mg/dl. Time-varying analyses showed a comparable TG level-fracture risk relationship. Associations between total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol levels and fractures were not observed. Conclusions: Midlife women with high fasting plasma TG had an increased risk of incident nontraumatic fracture. Secondary Abstract: Midlife women with fasting plasma triglyceride (TG) of at least 300 mg/dl had 2.5-fold greater hazards of fracture in 2 years later and onward, compared to those with TG below 150 mg/dl, in a multiethnic cohort. Time-varying analyses revealed comparable results.

Original languageEnglish (US)
Pages (from-to)3297-3305
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number9
StatePublished - Sep 1 2016

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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