Tags

Type your tag names separated by a space and hit enter

Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women.
J Musculoskelet Neuronal Interact. 2004 Mar; 4(1):50-63.JM

Abstract

In osteoporosis, the main cause for concern is the increase in the risk of fractures. The level of bone mineral density (BMD) measured by various techniques has been shown to be a strong predictor of fracture risk in postmenopausal women. However, half of patients with incident fractures have BMD value above the diagnostic threshold of osteoporosis defined as a T-score of -2.5 SD or more below the average value of young healthy women. Clearly there is a need for improvement in the identification of patients at risk for fracture. Several prospective studies have shown that an increased bone resorption evaluated by specific biochemical markers was associated with increased risk of the hip, spine and non-vertebral fractures independently of BMD. The use of bone markers in individual patients may be appropriate in some situations, especially in women who are not detected at risk by BMD measurements. For example, in the OFELY study including 668 postmenopausal women followed prospectively over 9 years, we found that among the 115 incident fractures, 54 (47%) actually occurred in non-osteoporotic women. Among these women, the combination of bone markers and history of previous fracture was highly predictive of fracture risk. Thus, bone markers may be used in the assessment of fracture risk in selected cases in which BMD and clinical risk factors are not enough to take a treatment decision. Advances in our knowledge of bone matrix biochemistry, most notably of post-translational modifications in type I collagen, may allow identification of biochemical markers that reflect changes in the material property of bone, which is an important determinant of bone strength. Preliminary in vitro studies indicate that the extent of post-translational modifications of collagen--which can be reflected in vivo by the measurement of the urinary ratio between native and isomerised type I collagen--play a role in determining the mechanical competence of cortical bone, independently of BMD. Further studies in osteoporosis should explore the changes in these biochemical parameters of bone matrix as they may represent a key component of bone quality.

Authors+Show Affiliations

Inserm Research Unit 403 and Synarc, Lyon, France. patrick.garnero@synarc.comNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15615078

Citation

Garnero, P, and P D. Delmas. "Contribution of Bone Mineral Density and Bone Turnover Markers to the Estimation of Risk of Osteoporotic Fracture in Postmenopausal Women." Journal of Musculoskeletal & Neuronal Interactions, vol. 4, no. 1, 2004, pp. 50-63.
Garnero P, Delmas PD. Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. J Musculoskelet Neuronal Interact. 2004;4(1):50-63.
Garnero, P., & Delmas, P. D. (2004). Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. Journal of Musculoskeletal & Neuronal Interactions, 4(1), 50-63.
Garnero P, Delmas PD. Contribution of Bone Mineral Density and Bone Turnover Markers to the Estimation of Risk of Osteoporotic Fracture in Postmenopausal Women. J Musculoskelet Neuronal Interact. 2004;4(1):50-63. PubMed PMID: 15615078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. AU - Garnero,P, AU - Delmas,P D, PY - 2004/12/24/pubmed PY - 2005/2/18/medline PY - 2004/12/24/entrez SP - 50 EP - 63 JF - Journal of musculoskeletal & neuronal interactions JO - J Musculoskelet Neuronal Interact VL - 4 IS - 1 N2 - In osteoporosis, the main cause for concern is the increase in the risk of fractures. The level of bone mineral density (BMD) measured by various techniques has been shown to be a strong predictor of fracture risk in postmenopausal women. However, half of patients with incident fractures have BMD value above the diagnostic threshold of osteoporosis defined as a T-score of -2.5 SD or more below the average value of young healthy women. Clearly there is a need for improvement in the identification of patients at risk for fracture. Several prospective studies have shown that an increased bone resorption evaluated by specific biochemical markers was associated with increased risk of the hip, spine and non-vertebral fractures independently of BMD. The use of bone markers in individual patients may be appropriate in some situations, especially in women who are not detected at risk by BMD measurements. For example, in the OFELY study including 668 postmenopausal women followed prospectively over 9 years, we found that among the 115 incident fractures, 54 (47%) actually occurred in non-osteoporotic women. Among these women, the combination of bone markers and history of previous fracture was highly predictive of fracture risk. Thus, bone markers may be used in the assessment of fracture risk in selected cases in which BMD and clinical risk factors are not enough to take a treatment decision. Advances in our knowledge of bone matrix biochemistry, most notably of post-translational modifications in type I collagen, may allow identification of biochemical markers that reflect changes in the material property of bone, which is an important determinant of bone strength. Preliminary in vitro studies indicate that the extent of post-translational modifications of collagen--which can be reflected in vivo by the measurement of the urinary ratio between native and isomerised type I collagen--play a role in determining the mechanical competence of cortical bone, independently of BMD. Further studies in osteoporosis should explore the changes in these biochemical parameters of bone matrix as they may represent a key component of bone quality. SN - 1108-7161 UR - https://www.unboundmedicine.com/medline/citation/15615078/Contribution_of_bone_mineral_density_and_bone_turnover_markers_to_the_estimation_of_risk_of_osteoporotic_fracture_in_postmenopausal_women_ L2 - http://www.ismni.org/jmni/pdf/15/08GARNERO.pdf DB - PRIME DP - Unbound Medicine ER -