Johansson M, et al. – In this study, researchers evaluated the role of four neuroendocrine activation and endothelial dysfunction biomarkers in the longitudinal prediction of fragility fractures. Study participants included 5,415 community-dwelling individuals (mean age, 68.9 ± 6.2 years) enrolled in the Malmö Preventive Project followed during 8.1 ± 2.9 years. The investigators determined the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures. According to results, in older adults, fragility fractures were independently predicted by elevated levels of MR-proADM and MR-proANP. Additionally, the risk of vertebral and femoral fractures increased by two-fold to three-fold in those with top quartile levels of all four biomarkers.