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. 2023 Feb 7;18(2):e0280854.
doi: 10.1371/journal.pone.0280854. eCollection 2023.

Nitric oxide is associated with fracture risk in Japanese women

Masataka Shiraki  1 , Tatsuhiko Kuroda  2 , Masaki Nakano  3 , Yukio Nakamura  3 , Mitsuru Saito  4 , Tomohiko Urano  5
Affiliations

Nitric oxide is associated with fracture risk in Japanese women

Masataka Shiraki et al. PLoS One. .

Abstract

Although nitric oxide (NO) is a known factor that regulates the bone physiology, few and discordant results have been obtained in human studies evaluating the effect of nitrates on bone health. We investigated for the relationship between serum NOx level and incident osteoporotic fracture rate prospectively in a cohort consisting of Japanese women. A total of 871 subjects (67.5 ± 10.8 y/o) were analyzed. During the observation period (8.8 ± 7.2 yrs), incident osteoporotic fractures occurred in 267 participants (209 vertebral fractures, 57 long-bone fractures, and 1 both types). Hazard ratio, by the Cox proportional hazards model, of serum NOx for incident fracture was 0.64 (95% confidence interval 0.53-0.78, p < 0.001) after adjustment for baseline age (1.13, 1.06-1.21, p < 0.001), lumbar bone mineral density (L-BMD; 0.85, 0.78-0.92, p < 0.001), presence of prevalent fracture (3.27, 2.49-4.32, p < 0.001), and treatment of osteoporosis (0.70, 0.53-0.92, p = 0.010). The relationships between serum level of NOx and bone-related parameters were examined by multiple regression analysis; body mass index (p < 0.001) and L-BMD (p = 0.011) were significantly associated with serum NOx level. These results suggest that the low circulating NOx is one of the independent predictors for osteoporotic fracture occurrence in postmenopausal women.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Time dependent fracture-free rates according to quartiles of the baseline NOx level.
Subjects were divided into 4 groups according to the baseline serum level of NOx. The lowest group exhibited significantly higher and more rapid susceptibility to incident osteoporotic fracture than those in the other groups (p < 0.001 by log-rank test).
See this image and copyright information in PMC

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The authors received no specific funding for this work.