Aspirin may increase BMD and reduce fracture risk: Study

Australia: Chronic low-grade inflammation contributes to age-related cardiovascular, neurological, respiratory and musculoskeletal conditions. Low-grade inflammation is associated with increased bone loss and fracture risk. Prostaglandin, an important inflammatory mediator, is likely to have a key role in bone remodelling attributable to inflammation.

Prostaglandin E2 stimulates bone resorption and formation and is produced largely from cyclooxygenase-2 induction. Prostaglandins acutely inhibit osteoclast function. However, their chronic effect is to stimulate bone resorption by increasing replication of osteoclast precursors, and differentiation to mature osteoclasts.

Aspirin is an inhibitor of prostaglandin production and may influence the cellular basis of bone remodelling responsible for maintaining the material and structural strength of bone. It is one of the most commonly used medications worldwide and has the potential to benefit and/or prevent many chronic diseases.

The researchers conducted a systematic review and exploratory meta-analysis of observational studies. This study was published in the British Medical Journal. A total of 12 studies were included in the meta-analysis, Electronic searches of MEDLINE and Embase, and a manual search of bibliographies was undertaken for studies published to 28 March 2018. Studies were included if participants were men or women aged ≥18 years; the exposure of interest was aspirin.Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklists for observational studies. Following are the findings:

1)Data pooled from six studies that included 511 390 people indicated aspirin was associated with a 17% lower odds of any fracture.

2)Aspirin was associated with a higher total hip BMD for women and men.

3)No meta-analyses were undertaken for femoral neck or total body BMD as there were too few studies.

While the advantages of decreased fracture risk and higher BMD from aspirin use may be modest for individuals, whether established in prospective controlled trials, they may give a large population benefit given the common use of aspirin in older people.

For further reading click on the following link,

http://dx.doi.org/10.1136/bmjopen-2018-026876