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Abstract：
BACKGROUND: The sphingosine 1-phosphate (S1P) concentration is a potential biomarker of osteoporotic fracture and is associated with both the fracture risk assessment tool (FRAX) probability and trabecular bone score (TBS), which are well-known predictors of fracture. We sought to estimate the effect of the S1P concentration on fracture risk using the FRAX probability and TBS as mediators.
METHODS: Plasma S1P concentrations, FRAX variables, and TBSs were measured in 66 postmenopausal women with fractures and 273 postmenopausal women without fractures. Associations between S1P concentration, FRAX probability, TBS, and fracture risk were analyzed using correlation, logistic regression, and mediation analyses.
RESULTS: Subjects in the highest S1P concentration tertile had a higher fracture risk (odds ratio [OR], 5.09; 95% confidence interval [CI], 2.22-11.67) than those in the lowest S1P concentration tertile before adjustment. Subjects in the highest FRAX probability tertile had a higher fracture risk (OR, 14.59; 95% CI, 5.01-42.53) than those in the lowest FRAX probability tertile before adjustment. Subjects in the lowest TBS tertile had a higher fracture risk (OR, 4.76; 95% CI, 2.28-9.93) than those in the highest TBS tertile before adjustment. After adjustment for FRAX probability and TBS, the highest S1P concentration tertile was still associated with a higher fracture risk (OR, 3.13; 95% CI, 1.28-7.66). The FRAX probability and TBS accounted for 32.6% and 21.7%, respectively, of the relationship between the S1P concentration and fracture risk.
CONCLUSIONS: The relationship between the circulating S1P concentration and fracture risk was partly mediated by the FRAX probability, bone microarchitecture, and other factors.
METHODS: Plasma S1P concentrations, FRAX variables, and TBSs were measured in 66 postmenopausal women with fractures and 273 postmenopausal women without fractures. Associations between S1P concentration, FRAX probability, TBS, and fracture risk were analyzed using correlation, logistic regression, and mediation analyses.
RESULTS: Subjects in the highest S1P concentration tertile had a higher fracture risk (odds ratio [OR], 5.09; 95% confidence interval [CI], 2.22-11.67) than those in the lowest S1P concentration tertile before adjustment. Subjects in the highest FRAX probability tertile had a higher fracture risk (OR, 14.59; 95% CI, 5.01-42.53) than those in the lowest FRAX probability tertile before adjustment. Subjects in the lowest TBS tertile had a higher fracture risk (OR, 4.76; 95% CI, 2.28-9.93) than those in the highest TBS tertile before adjustment. After adjustment for FRAX probability and TBS, the highest S1P concentration tertile was still associated with a higher fracture risk (OR, 3.13; 95% CI, 1.28-7.66). The FRAX probability and TBS accounted for 32.6% and 21.7%, respectively, of the relationship between the S1P concentration and fracture risk.
CONCLUSIONS: The relationship between the circulating S1P concentration and fracture risk was partly mediated by the FRAX probability, bone microarchitecture, and other factors.
摘要：
背景：1-磷酸鞘氨醇（S1P）浓度是骨质疏松性骨折的潜在生物标志物，并且与骨折风险评估工具（FRAX）概率和骨小梁评分（TBS）相关，这是众所周知的骨折预测因子。我们试图使用FRAX概率和TBS作为介体来估计S1P浓度对骨折风险的影响。
方法：血浆S1P浓度，FRAX变量,在66名绝经后骨折妇女和273名绝经后无骨折妇女中测量了TBS。S1P浓度之间的关联，FRAX概率,TBS,和骨折风险进行了相关性分析，逻辑回归，调解分析。
结果：S1P浓度最高的受试者具有较高的骨折风险（比值比[OR]，5.09；95%置信区间[CI]，2.22-11.67）比调整前最低S1P浓度三分位数中的那些。FRAX概率最高的受试者骨折风险较高(OR，14.59；95%CI，5.01-42.53）比调整前FRAX概率最低的那些。处于最低TBS三分位数的受试者骨折风险较高(OR，4.76；95%CI，2.28-9.93）比调整前TBS最高的人群高。调整FRAX概率和TBS后，最高的S1P浓度仍然与较高的骨折风险相关(OR，3.13；95%CI，1.28-7.66）。FRAX概率和TBS分别占32.6%和21.7%，分别,S1P浓度与骨折风险之间的关系。
结论：循环S1P浓度与骨折风险之间的关系部分由FRAX概率介导，骨微结构，和其他因素。
方法：血浆S1P浓度，FRAX变量,在66名绝经后骨折妇女和273名绝经后无骨折妇女中测量了TBS。S1P浓度之间的关联，FRAX概率,TBS,和骨折风险进行了相关性分析，逻辑回归，调解分析。
结果：S1P浓度最高的受试者具有较高的骨折风险（比值比[OR]，5.09；95%置信区间[CI]，2.22-11.67）比调整前最低S1P浓度三分位数中的那些。FRAX概率最高的受试者骨折风险较高(OR，14.59；95%CI，5.01-42.53）比调整前FRAX概率最低的那些。处于最低TBS三分位数的受试者骨折风险较高(OR，4.76；95%CI，2.28-9.93）比调整前TBS最高的人群高。调整FRAX概率和TBS后，最高的S1P浓度仍然与较高的骨折风险相关(OR，3.13；95%CI，1.28-7.66）。FRAX概率和TBS分别占32.6%和21.7%，分别,S1P浓度与骨折风险之间的关系。
结论：循环S1P浓度与骨折风险之间的关系部分由FRAX概率介导，骨微结构，和其他因素。
