Evidence map›Paper›PMID 39982456›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population.

Lu Guo, Nan Zhang, Xinhao Fan, Xiaoli Hou, Man Li, Wenqi Xu, Peipei Liu, Lei Xing, Jingyao Wang, Shuohua Chen and 2 more

Abstract read
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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lu GuoSchool of Public Health, Hebei Key Laboratory for Organ Fibrosis Research, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis. Tangshan, 063200, Hebei, China.
Nan ZhangKailuan General Hospital, Tangshan, Hebei, China.
Xinhao FanKailuan General Hospital, Tangshan, Hebei, China.
Xiaoli HouSchool of Public Health, Hebei Key Laboratory for Organ Fibrosis Research, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis. Tangshan, 063200, Hebei, China.
Man LiDepartment of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Wenqi XuFirst Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Peipei LiuSchool of Public Health, Hebei Key Laboratory for Organ Fibrosis Research, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis. Tangshan, 063200, Hebei, China.
Lei XingDepartment of General Practice, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China.
Jingyao WangThe School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China.
Shuohua ChenKailuan General Hospital, Tangshan, Hebei, China.
Shouling WuKailuan General Hospital, Tangshan, Hebei, China. drwusl@163.com.
Faming TianSchool of Public Health, Hebei Key Laboratory for Organ Fibrosis Research, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis. Tangshan, 063200, Hebei, China. tfm9911316@163.com.ORCID http://orcid.org/0000-0001-7083-3380

Funding

Central government-guided local science and technology development foundation of Hebei Province 246Z7744Gthe Central Government-guided Local Science and Technology Development Foundation of Hebei Province 226Z7709Gthe Natural Science Foundation of Hebei Province H2020209266
6 · The paper itself

Abstract

This study explored the association between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in Chinese males. Results show that elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders. PURPOSE: This study investigates the relationship between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in a Chinese male population.

methodsA total of 48,186 male participants (age range 18-98 years old, average age 53.92 years) at baseline were recruited from the Kailuan Study and followed up for outcomes until 2022. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident fragility fractures. The dose response between CAR and fracture risk was analyzed using restricted cubic splines. Additionally, the concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI) were utilized to assess the incremental predictive value of various indicators for the discrimination of fragility fractures.

resultsDuring an average follow-up of 11.17 years, 728 incident fragility fractures occurred among the 48,186 participants. Compared to participants in the second quartile of CAR, those in the highest quartile had a 49% increased risk of fragility fractures (HR = 1.49, 95% CI = 1.21-1.84) after adjusting for risk factors. Restricted cubic spline analysis showed a nonlinear relationship between CAR and the risk of fragility fractures. The C-index, continuous NRI, and IDI for predicting the risk of fragility fractures were 61.142%, 0.089 (p < 0.05), and 0.00009 (p < 0.05), respectively, which were higher than those of hs-CRP (C-index 0.6137, NRI 0.086, IDI 0.000074) and albumin (C- index 0.6116, NRI 0.068, IDI - 0.000004).

conclusionElevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.

Indexed as

C-Reactive ProteinOsteoporotic FracturesSerum AlbuminAdolescentAdultAgedAged, 80 and overBiomarkersChinaEast Asian PeopleFollow-Up StudiesHumansIncidenceMaleMiddle AgedRisk AssessmentBiomarkersC-Reactive ProteinSerum AlbuminCohort studyFragility fractureHypersensitive C-reactive protein to albumin ratioMale population

Identifiers

PMID39982456

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.