Caffeine intake among women ≥50 years may be associated with a small but significant decrease in bone mineral density (BMD) at the femoral neck and may increase the risk of hip fractures, according to data presented at the 2017 ACR/ARHP Annual Meeting.

In vitro studies suggest that direct stimulation of the adenosine A2A receptor increases osteoblasts and diminishes osteoclasts, and thus inhibition of these receptors might promote osteoporosis,” said Nicole Berman MD, lead author of the study. “Caffeine is a regular part of many adult diets and acts in part by engaging adenosine receptors.”

To investigate the effect of caffeine on osteoporosis risk and fractures, the researchers used the 2013–14 cycle of the National Health and Nutrition Examination Survey (NHANES) for analysis. This included 10,175 individuals who underwent a 24-hour dietary recall interview; bone mineral density (BMD) was evaluated using Dual Energy X-ray Absorptiometry (DEXA) at the hip and spine. 

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Subpopulations of those over 40 years old (n=3,210) and of Caucasian females over 50 years old (n=682) were examined; adjustments were made for age, body mass index, physical activity, prior corticosteroid use, smoking and alcohol use.

Results of the multivariate analysis demonstrated that caffeine intake was associated with hip fractures (P=0.01) and decreased femoral neck BMD (P=0.05) in women over 50 years; this association was not present in the univariate analysis and in Caucasian men over 50. For the subpopulation of women and men over 40 years, caffeine intake was associated with a decrease in femoral neck BMD (P<0.001) and spine fractures (P<0.001) in the multivariate analysis.

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