Association between bone mineral density and C-reactive protein in a large population-based sample

OBJECTIVE: Several studies suggest that bone mineral density (BMD) is reduced in chronic inflammatory diseases. Higher serum levels of C-reactive protein (CRP) have been associated with lower BMD in women and older adults. However, whether this association holds in a representative sample of the general population is unclear. The purpose of this study was to examine the relationship between BMD and CRP in a large representative US population-based sample from the National Health and Nutrition Examination Survey (NHANES). METHODS: We included participants aged 20+ with BMD (total and subregions) measured by dual-energy x-ray absorptiometry (DXA) scans and complete information on covariates from NHANES now. The association between CRP and BMD was evaluated using multivariable linear regression models, adjusting for potential confounders and further adjustment for comorbid diseases, medications and serum vitamin D levels. RESULTS: The study sample included 10,475 participants, among which there were 53% Caucasians, 22% Mexican-American, 18% African-American, and 7% were other races. Men had higher BMD and lower CRP concentrations than women. BMD (total, subtotal, extremities, ribs, and trunk subregions) was inversely associated with CRP quintiles both in men and women in a dose-dependent fashion (total BMD p for trend: