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Bone turnover markers and prediction of fracture: a prospective follow-up study of 1040 elderly women for a mean of 9 years.

Abstract

Osteoporosis is characterized by compromised bone mass and strength, predisposing to an increased risk of fracture. Increased bone metabolism has been suggested to be a risk factor for fracture. The aim of this study was to evaluate whether baseline bone turnover markers are associated with long-term incidence of fracture in a population-based sample of 1040 women who were 75 years old (Malmö OPRA study). Seven bone markers (S-TRACP5b, S-CTX-I, S-OC[1-49], S-TotalOC, S-cOC, S-boneALP, and urinary osteocalcin) were measured at baseline and 1-year follow-up visit. During the mean follow-up of 9.0 years (range 7.4-10.9), 363 women sustained at least one fracture of any type, including 116 hip fractures and 103 clinical vertebral fractures. High S-TRACP5b and S-CTX-I levels were associated with increased risk of any fracture with hazard ratios [HRs (95% confidence interval)] of 1.16 (1.04-1.29) and 1.13 (1.01-1.27) per SD increase, respectively. They also were associated with increased risk of clinical vertebral fracture with HRs of 1.22 (1.01-1.48) and 1.32 (1.05-1.67), respectively. Markers were not associated with risk for hip fracture. Results were similar when we used resorption markers, including urinary osteocalcin, measured at the 1-year visit or an average of the two measurements. The HRs were highest for any fracture in the beginning of the follow-up period, 2.5 years from baseline. For vertebral fractures, the association was more pronounced and lasted for a longer period of time, at least for 5 years. In conclusion, elevated levels of S-TRACP5b, S-CTX-I, and urinary osteocalcin are associated with increased fracture risk for up to a decade in elderly women.

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  • Authors+Show Affiliations

    ,

    Clinical and Molecular Osteoporosis Research Unit, Lund University, Department of Orthopaedics, Malmö University Hospital, SE-20502 Malmö, Sweden. kaisa.ivaska@utu.fi

    , , ,

    Source

    MeSH

    Aged
    Biomarkers
    Bone Density
    Bone Resorption
    Female
    Follow-Up Studies
    Fractures, Bone
    Hip Fractures
    Humans
    Incidence
    Osteoporosis, Postmenopausal
    Risk Factors
    Time Factors

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    19961336

    Citation

    Ivaska, Kaisa K., et al. "Bone Turnover Markers and Prediction of Fracture: a Prospective Follow-up Study of 1040 Elderly Women for a Mean of 9 Years." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 25, no. 2, 2010, pp. 393-403.
    Ivaska KK, Gerdhem P, Väänänen HK, et al. Bone turnover markers and prediction of fracture: a prospective follow-up study of 1040 elderly women for a mean of 9 years. J Bone Miner Res. 2010;25(2):393-403.
    Ivaska, K. K., Gerdhem, P., Väänänen, H. K., Akesson, K., & Obrant, K. J. (2010). Bone turnover markers and prediction of fracture: a prospective follow-up study of 1040 elderly women for a mean of 9 years. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 25(2), pp. 393-403. doi:10.1359/jbmr.091006.
    Ivaska KK, et al. Bone Turnover Markers and Prediction of Fracture: a Prospective Follow-up Study of 1040 Elderly Women for a Mean of 9 Years. J Bone Miner Res. 2010;25(2):393-403. PubMed PMID: 19961336.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Bone turnover markers and prediction of fracture: a prospective follow-up study of 1040 elderly women for a mean of 9 years. AU - Ivaska,Kaisa K, AU - Gerdhem,Paul, AU - Väänänen,H Kalervo, AU - Akesson,Kristina, AU - Obrant,Karl J, PY - 2009/12/8/entrez PY - 2009/12/8/pubmed PY - 2010/10/12/medline SP - 393 EP - 403 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 - 25 IS - 2 N2 - Osteoporosis is characterized by compromised bone mass and strength, predisposing to an increased risk of fracture. Increased bone metabolism has been suggested to be a risk factor for fracture. The aim of this study was to evaluate whether baseline bone turnover markers are associated with long-term incidence of fracture in a population-based sample of 1040 women who were 75 years old (Malmö OPRA study). Seven bone markers (S-TRACP5b, S-CTX-I, S-OC[1-49], S-TotalOC, S-cOC, S-boneALP, and urinary osteocalcin) were measured at baseline and 1-year follow-up visit. During the mean follow-up of 9.0 years (range 7.4-10.9), 363 women sustained at least one fracture of any type, including 116 hip fractures and 103 clinical vertebral fractures. High S-TRACP5b and S-CTX-I levels were associated with increased risk of any fracture with hazard ratios [HRs (95% confidence interval)] of 1.16 (1.04-1.29) and 1.13 (1.01-1.27) per SD increase, respectively. They also were associated with increased risk of clinical vertebral fracture with HRs of 1.22 (1.01-1.48) and 1.32 (1.05-1.67), respectively. Markers were not associated with risk for hip fracture. Results were similar when we used resorption markers, including urinary osteocalcin, measured at the 1-year visit or an average of the two measurements. The HRs were highest for any fracture in the beginning of the follow-up period, 2.5 years from baseline. For vertebral fractures, the association was more pronounced and lasted for a longer period of time, at least for 5 years. In conclusion, elevated levels of S-TRACP5b, S-CTX-I, and urinary osteocalcin are associated with increased fracture risk for up to a decade in elderly women. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/19961336/Bone_turnover_markers_and_prediction_of_fracture:_a_prospective_follow_up_study_of_1040_elderly_women_for_a_mean_of_9_years_ L2 - https://doi.org/10.1359/jbmr.091006 DB - PRIME DP - Unbound Medicine ER -