Higher serum concentrations of dietary antioxidants are associated with lower levels of inflammatory biomarkers during the year after hip fracture

Background & aims: Chronic inflammation impairs recovery among the 1.6 million people who suffer from hip fracture annually. Vitamin E and the carotenoids are two classes of dietary antioxidants with profound anti-inflammatory effects, and the goal of this study was to assess whether higher post-fracture concentrations of these antioxidants were associated with lower levels of interleukin 6 (IL-6) and the soluble receptor for tumor necrosis factor-alpha (sTNF-alpha R1), two common markers of inflammation. Methods: Serum concentrations of the dietary antioxidants and inflammatory markers were assessed at baseline and 2, 6, and 12 month follow-up visits among 148 hip fracture patients from The Baltimore Hip Studies. Generalized estimating equations modeled the relationship between baseline and time-varying antioxidant concentrations and inflammatory markers. Results: Higher post-fracture concentrations of vitamin E and the carotenoids were associated with lower levels of inflammatory markers. Associations were strongest at baseline, particularly between the alpha-tocopherol form of vitamin E and sTNF-alpha R1 (p = 0.05) and total carotenoids and both sTNF-alpha R1(p = 0.01) and IL-6 (p = 0.05). Higher baseline and time-varying alpha-carotene and time-varying lutein concentrations were also associated with lower sTNF-alpha R1 at all post-fracture visits (p <= 0.05). Conclusions: These findings suggest that a clinical trial increasing post-fracture intake of vitamin E and the carotenoids may be warranted. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.