Plasma Sphingosine 1-Phosphate Levels and the Risk of Vertebral Fracture in Postmenopausal Women

Context: Although sphingosine 1-phosphate (S1P) plays diverse roles in bone metabolism, the most prominent role seems to be the augmentation of bone resorption. Objective: The objective of the study was to investigate the possibility of using S1P as a predictor for osteoporotic vertebral fracture (VF) risk. Design and Setting: This was a case-control study conducted in a clinical unit in Korea. Participants: Sixty-nine cases having radiological VF and 69 age- and body mass index-matched controls among 460 eligible postmenopausal women participated in the study. Main Outcome Measures: Lateral thoracolumbar radiographs, bone mineral density (BMD), bone turnover markers, and plasma S1P levels were obtained from all subjects. Results: S1P levels were markedly higher in subjects with VF (7.49 ± 3.44 μmol/liter) than in those without VF (5.58 ± 2.01 μmol/liter; P = 0.001) and increased in a dose-response manner as the number of VF increased (P for the trend <0.001), even after adjustment for lumbar spine BMD an...