High-Sensitivity C-Reactive Protein and Risk of Fracture: A Meta-Analysis of Prospective Studies

• Activity Number: 460 - Causal Methods for Discovery, Confirmation and Mechanistic Evaluation
• Type: Contributed
• Date/Time: Thursday, August 6, 2020 : 10:00 AM to 2:00 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Qing Wu* and Heejin Mun and Bowen Liu and Thu Huynh Anh Pham
• Companies: University of Nevada, Las Vegas and UNLV and UNLV and UNLV
• Keywords: Meta-analysis; random-effect model; heterogeneity; fracture; osteoporosis; C-reactive protein

Abstract

The association between inflammatory marker high-sensitivity C-reactive protein (hs-CRP) and osteoporotic fracture in adults remains uncertain. We conducted a meta-analysis to examine the effects of a high level of hs-CRP on the risk of fracture. We searched PubMed, Embase, and MEDLINE and identified ten eligible cohort studies for this meta-analysis. Two investigators independently conducted study selection, appraisal, and data abstraction using a standardized protocol. Random effect models were employed for the meta-analysis. Each study was weighted by the reciprocal of its variance. Higgin’s I2 and Cochran’s Q statistics were employed to assess heterogeneity. Overall, the RR for fracture as of a comparison of individuals in the top tertile with individuals in the bottom tertile of hs-CRP is 1.62 (1.30, 2.03) (p< 0.0001). Higgin’s I2 (60.2 %) and Cochran’s Q statistic (p < 0.01) suggests there was moderate heterogeneity for our meta-analysis. All estimates are consistent in sensitivity analyses and subgroup analyses. This meta-analysis demonstrated that the high level of hs-CRP is associated with a significant increased risk in osteoporotic fracture.