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Biochemical markers of bone metabolism and prediction of fracture in elderly women.
J Bone Miner Res 2004; 19(3):386-93JB

Abstract

We studied the ability of various markers of bone turnover to predict fracture in 1040 randomly recruited 75-year-old women. A total of 178 of the women sustained at least one fracture during follow-up (mean, 4.6 years). In elderly women, TRACP5b and urinary fragments of osteocalcin are promising new markers for prediction of fracture, in particular, vertebral fracture.

INTRODUCTION

Biochemical markers reflecting bone turnover may improve the prediction of fractures.

MATERIALS AND METHODS

The ability of 10 markers of bone turnover to predict fracture in 1040 elderly women in the Malmö OPRA study was studied. Serum bone-specific alkaline phosphatase and four different forms of serum osteocalcin (S-OC) were analyzed as markers of bone formation and serum C-terminal cross-linking telopeptides of type I collagen (S-CTX), serum TRACP isoform 5b (S-TRACP5b) and urinary free deoxypyridinoline (U-DPD) as markers of bone resorption. Two novel assays for osteocalcin fragments in urine (U-OC) were analyzed. Areal BMD (aBMD) was measured by DXA in the femoral neck and lumbar spine.

RESULTS

In total, 231 fractures were sustained by 178 of the women during a 3- to 6.5-year (mean, 4.6 years) follow-up period. When women with prospective fractures were compared with women without fractures, S-TRACP5b, S-CTX, one S-OC, and one U-OC were higher in women with a fracture of any type (all p < 0.05), and all bone markers were higher in women with clinical vertebral fracture (all p < 0.05). Markers were not significantly elevated in women with hip fracture. When women within the highest quartile of a bone marker were compared with all others, S-TRACP5b and one U-OC predicted the occurrence of a fracture of any type (odds ratio [OR]), 1.55 and 1.53; p < 0.05). S-TRACP5b, the two U-OCs, and S-CTX predicted vertebral fracture (OR, 2.28, 2.75, 2.71, and 1.94, respectively; all p < 0.05), and the predictive value remained significant for S-TRACP5b and the two U-OCs after adjusting for aBMD (OR, 2.02-2.25; p < 0.05). Bone markers were not able to predict hip fracture.

CONCLUSION

These results show that biochemical markers of bone turnover can predict fracture, and in particular, fractures that engage trabecular bone. S-TRACP5b and U-OC are promising new markers for prediction of fracture.

Authors+Show Affiliations

Departments of Orthopedics, Malmö University Hospital, Malmö, Sweeden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15040826

Citation

Gerdhem, Paul, et al. "Biochemical Markers of Bone Metabolism and Prediction of Fracture in Elderly Women." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 19, no. 3, 2004, pp. 386-93.
Gerdhem P, Ivaska KK, Alatalo SL, et al. Biochemical markers of bone metabolism and prediction of fracture in elderly women. J Bone Miner Res. 2004;19(3):386-93.
Gerdhem, P., Ivaska, K. K., Alatalo, S. L., Halleen, J. M., Hellman, J., Isaksson, A., ... Obrant, K. J. (2004). Biochemical markers of bone metabolism and prediction of fracture in elderly women. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 19(3), pp. 386-93.
Gerdhem P, et al. Biochemical Markers of Bone Metabolism and Prediction of Fracture in Elderly Women. J Bone Miner Res. 2004;19(3):386-93. PubMed PMID: 15040826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biochemical markers of bone metabolism and prediction of fracture in elderly women. AU - Gerdhem,Paul, AU - Ivaska,Kaisa K, AU - Alatalo,Sari L, AU - Halleen,Jussi M, AU - Hellman,Jukka, AU - Isaksson,Anders, AU - Pettersson,Kim, AU - Väänänen,H Kalervo, AU - Akesson,Kristina, AU - Obrant,Karl J, Y1 - 2003/12/22/ PY - 2003/07/03/received PY - 2003/10/15/revised PY - 2003/10/30/accepted PY - 2004/3/26/pubmed PY - 2004/12/16/medline PY - 2004/3/26/entrez SP - 386 EP - 93 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 19 IS - 3 N2 - UNLABELLED: We studied the ability of various markers of bone turnover to predict fracture in 1040 randomly recruited 75-year-old women. A total of 178 of the women sustained at least one fracture during follow-up (mean, 4.6 years). In elderly women, TRACP5b and urinary fragments of osteocalcin are promising new markers for prediction of fracture, in particular, vertebral fracture. INTRODUCTION: Biochemical markers reflecting bone turnover may improve the prediction of fractures. MATERIALS AND METHODS: The ability of 10 markers of bone turnover to predict fracture in 1040 elderly women in the Malmö OPRA study was studied. Serum bone-specific alkaline phosphatase and four different forms of serum osteocalcin (S-OC) were analyzed as markers of bone formation and serum C-terminal cross-linking telopeptides of type I collagen (S-CTX), serum TRACP isoform 5b (S-TRACP5b) and urinary free deoxypyridinoline (U-DPD) as markers of bone resorption. Two novel assays for osteocalcin fragments in urine (U-OC) were analyzed. Areal BMD (aBMD) was measured by DXA in the femoral neck and lumbar spine. RESULTS: In total, 231 fractures were sustained by 178 of the women during a 3- to 6.5-year (mean, 4.6 years) follow-up period. When women with prospective fractures were compared with women without fractures, S-TRACP5b, S-CTX, one S-OC, and one U-OC were higher in women with a fracture of any type (all p < 0.05), and all bone markers were higher in women with clinical vertebral fracture (all p < 0.05). Markers were not significantly elevated in women with hip fracture. When women within the highest quartile of a bone marker were compared with all others, S-TRACP5b and one U-OC predicted the occurrence of a fracture of any type (odds ratio [OR]), 1.55 and 1.53; p < 0.05). S-TRACP5b, the two U-OCs, and S-CTX predicted vertebral fracture (OR, 2.28, 2.75, 2.71, and 1.94, respectively; all p < 0.05), and the predictive value remained significant for S-TRACP5b and the two U-OCs after adjusting for aBMD (OR, 2.02-2.25; p < 0.05). Bone markers were not able to predict hip fracture. CONCLUSION: These results show that biochemical markers of bone turnover can predict fracture, and in particular, fractures that engage trabecular bone. S-TRACP5b and U-OC are promising new markers for prediction of fracture. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15040826/Biochemical_markers_of_bone_metabolism_and_prediction_of_fracture_in_elderly_women_ L2 - https://doi.org/10.1359/JBMR.0301244 DB - PRIME DP - Unbound Medicine ER -