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Blood and Bone - Epidemiological studies on the association between blood and bone

Sammanfattning
Introduction: Preclinical and clinical studies have suggested that blood- and bone cells are interconnected. Aims: To study the association between hematological variables, specifically serotonin, erythropoietin (EPO), hemoglobin (Hb), neutrophil-, lymphocyte-, and platelet count, and bone mineral density (BMD), and/or risk for fractures (paper I-III). To study the risk for hip fractures in patients with lymphoma (paper IV). Methods: In paper I-III data from MrOS (The Osteoporotic Fractures in Men Study), a prospective, population-based study, was used. Men in the ages 69-81 years were randomly selected from Gothenburg (n=1010), 2002-2004. In the second part of paper I, additional cohorts from Uppsala and Malmö were used. Baseline data included blood tests (serotonin, EPO, Hb, neutrophil-, lymphocyte-, and platelet count) and dual x-ray absorptiometry (DXA). Subjects were followed until the end of 2013. In paper IV adults ≥18 years diagnosed with lymphoma between 1995 and 2015 were identified in the Swedish Cancer Register. Data on the Swedish population and lymphoma patients was retrieved from Statistiska Centralbyrån, and hip fractures were identified via the Inpatient Register. The risk for hip fractures in patients with lymphoma was compared with that of the Swedish population. Results: Serotonin was negatively associated with total hip BMD. Men with serotonin in quintile 5 had an increased risk for all fractures, nonvertebral osteoporotic fractures and hip fractures. In men with normal renal function EPO was positively associated with total hip BMD, inflammation, and comorbidities, as well as increased risk for all fractures and major osteoporotic fractures. Platelet- and neutrophil count, and not Hb and lymphocyte count, were negatively associated with total hip BMD. Women with lymphoma had increased risk for hip fracture compared with the Swedish population. Conclusions: The results support the hypothesis that blood and bone are interconnected. Serotonin and EPO both predict for fractures in elderly men. Platelet- and neutrophil count are associated with BMD. Physicians treating lymphoma patients should be aware of the increased risk for hip fractures in women.
Delarbeten
I. Kristjansdottir H.L., Lewerin C., Lerner U.H., Waern E., Johansson H., Sundh D., Karlsson M., Cummings S.R., Zetterberg H., Lorentzon M., Ohlsson C, Mellström D. High Serum Serotonin Predicts Increased Risk for Hip Fracture and Nonvertebral Osteoporotic Fractures: The MrOS Sweden Study. J Bone Miner Res. 2018;33(9): 1560-1567. ::doi::10.1002/jbmr.3443
 
II. Kristjansdottir H.L., Lewerin C., Lerner U.H., Herlitz H., Johansson P., Johansson H., Karlsson M., Lorentzon M., Ohlsson C., Ljunggren Ö., Mellström D. High Plasma Erythropoietin Predicts Incident Fractures in Elderly Men with Normal Renal Function: The MrOS Sweden Cohort. J Bone Miner Res. 2020;35(2): 298-305. ::DOI::10.1007/s00198-020-05766-6
 
III. Kristjansdottir H.L., Mellström D., Johansson P., Karlsson M., Vandenput L., Lorentzon M., Herlitz H., Ohlsson C., Lerner U.H., Lewerin C. High platelet count is associated with low bone mineral density: The MrOS Sweden cohort. Osteoporos Int. 2021; 32: 865-871. ::DOI::10.1007/s00198-020-05766-6
 
IV. Johansson P., Lind Kristjansdottir H., Johansson H., Jakir A., Mellström D., Lewerin C. Increased Risk of Hip Fracture in Patients with Lymphoma, a Swedish Population Study of 37,236 Lymphoma Patients. Calcif Tissue Int. 2020;106(6): 591-598. ::DOI::10.1007/s00223-020-00674-7
 
Examinationsnivå
Doctor of Philosophy (Medicine)
Universitet
University of Gothenburg. Sahlgrenska Academy
Institution
Inst of Medicine. Department of Internal Medicine and Clinical Nutrition
Disputation
Fredagen 28 maj 2021 kl. 9.00, Hörsal Arvid Carlsson, Academicum, Medicinaregatan 3, Göteborg
Datum för disputation
2021-05-28
E-post
hallgerdur.kristjansdottir@vgregion.se
URL:
http://hdl.handle.net/2077/67647
Samlingar
  • Doctoral Theses / Doktorsavhandlingar Institutionen för medicin
  • Doctoral Theses from Sahlgrenska Academy
  • Doctoral Theses from University of Gothenburg / Doktorsavhandlingar från Göteborgs universitet
Fil(er)
Thesis frame (3.129Mb)
Cover (9.923Mb)
Abstract (147.3Kb)
Datum
2021-05-07
Författare
Kristjansdottir, Hallgerdur Lind
Nyckelord
Blood
Bone
Fractures
Osteoporosis
Publikationstyp
Doctoral thesis
ISBN
978-91-8009-244-9 (PRINT)
978-91-8009-245-6 (PDF)
Språk
eng
Metadata
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