Association of blood n-3 fatty acid with bone mass and bone marrow TRAP-5b in the elderly with and without hip fracture

B. J. Kim, H. J. Yoo, S. J. Park, M. K. Kwak, S. H. Lee, S. J. Kim, Mark W Hamrick, Carlos M Isales, S. H. Ahn, J. M. Koh

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Summary: The plasma n-3 fatty acid level was 26.2% lower in patients with osteoporotic hip fracture than in those with osteoarthritis. In all patients, n-3 fatty acid was positively associated with bone mineral density and inversely associated with tartrate-resistant acid phosphatase-5b level in bone marrow aspirates, reflecting the bone microenvironment. Introduction: Despite the potential beneficial role of n-3 fatty acid (FA) on bone metabolism, the specific mechanisms underlying these effects in humans remain unclear. Here, we assessed whether the plasma n-3 level, as an objective indicator of its status, is associated with osteoporosis-related phenotypes and bone-related markers in human bone marrow (BM) samples. Methods: This was a case-control and cross-sectional study conducted in a clinical unit. n-3 FA in the blood and bone biochemical markers in the BM aspirates were measured by gas chromatography/mass spectrometry and immunoassay, respectively. BM fluids were collected from 72 patients who underwent hip surgery because of either osteoporotic hip fracture (HF; n = 28) or osteoarthritis (n = 44). Results: After adjusting for confounders, patients with HF had 26.2% lower plasma n-3 levels than those with osteoarthritis (P = 0.006), and each standard deviation increment in plasma n-3 was associated with a multivariate-adjusted odds ratio of 0.40 for osteoporotic HF (P = 0.010). In multivariate analyses including all patients, a higher plasma n-3 level was associated with higher bone mass at the lumbar spine (β = 0.615, P = 0.002) and total femur (β = 0.244, P = 0.045). Interestingly, the plasma n-3 level was inversely associated with the tartrate-resistant acid phosphatase-5b level (β = − 0.633, P = 0.023), but not with the bone-specific alkaline phosphatase level, in BM aspirates. Conclusions: These findings provide clinical evidence that n-3 FA is a potential inhibitor of osteoclastogenesis that favors human bone health.

Original languageEnglish (US)
Pages (from-to)1071-1078
Number of pages8
JournalOsteoporosis International
Issue number5
StatePublished - May 1 2019


  • Bone mass
  • Bone resorption
  • Osteoporotic fracture
  • n-3 fatty acid

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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