Oxidative stress and bone mineral density in elderly men: Antioxidant activity of alpha-tocopherol

Oxidative stress has recently been identified as a pivotal pathogenetic factor of bone loss in mice, but its importance in humans is not clear. We aimed to investigate the association between urinary 8-iso-PGF2α levels, a major F2-isoprostane and a reliable in vivo biomarker of oxidative stress, and bone mineral density (BMD), and to study whether vitamin E in the form of serum α-tocopherol, a scavenger of peroxyl radicals, modifies the association. In 405 men, urinary 8-iso-PGF2α and serum α-tocopherol were measured at age 77 years and BMD at age 82 years. One SD increase in 8-iso-PGF2α corresponded to an approximately 2–4% decrease in average adjusted BMD values of total body, lumbar spine, and proximal femur (all P < 0.001). Serum α-tocopherol levels seemed to modify the association between urinary 8-iso-PGF2α and BMD. Men with α-tocopherol levels below the median combined with high oxidative stress, i.e., 8-iso-PGF2α above the median, had 7% (95% CI 3–11%) lower BMD at the lumbar spine and 5% (95% CI 2–9%) lower BMD at the proximal femur. In elderly men high oxidative stress is associated with reduced BMD, which is more pronounced in individuals with low serum levels of the antioxidant vitamin E.