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Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study.
J Bone Miner Res 1996; 11(10):1531-8JB

Abstract

Increased bone turnover has been suggested as a potential risk factor for osteoporotic fractures. We investigated this hypothesis in a prospective cohort study performed on 7598 healthy women more than 75 years of age. One hundred and twenty-six women (mean years 82.5) who sustained a hip fracture during a mean 22-month follow-up were age-matched with three controls who did not fracture. Baseline samples were collected prior to fracture for the measurement of two markers of bone formation and three urinary markers of bone resorption: type I collagen cross-linked N- (NTX) or C-telopeptide (CTX) and free deoxypyridinoline (free D-Pyr). Elderly women had increased bone formation and resorption compared with healthy premenopausal women. Urinary excretion of CTX and free D-Pyr, but not other markers, was higher in patients with hip fracture than in age-matched controls (p = 0.02 and 0.005, respectively). CTX and free D-Pyr excretion above the upper limit of the premenopausal range was associated with an increased hip fracture risk with an odds ratio (95% confidence interval) of 2.2 (1.3-3.6) and 1.9 (1.1-3.2), respectively, while markers of formation were not. Increased bone resorption predicted hip fracture independently of bone mass, i.e., after adjustment for femoral neck bone mineral density (BMD) and independently of mobility status assessed by the gait speed. Women with both a femoral BMD value of 2.5 SD or more below the mean of young adults and either high CTX or high free D-Pyr levels were at greater risk of hip fracture, with an odds ratio of 4.8 and 4.1, respectively, than those with only low BMD or high bone resorption. Elderly women are characterized by increased bone turnover, and some markers of bone resorption predict the subsequent risk of hip fracture independently of hip BMD. Combining the measurement of BMD and bone resorption may be useful to improve the assessment of the risk of hip fracture in elderly women.

Authors+Show Affiliations

INSERM Unit 403, Hôpital E. Herriot, Lyon, France.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

8889854

Citation

Garnero, P, et al. "Markers of Bone Resorption Predict Hip Fracture in Elderly Women: the EPIDOS Prospective Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 11, no. 10, 1996, pp. 1531-8.
Garnero P, Hausherr E, Chapuy MC, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Miner Res. 1996;11(10):1531-8.
Garnero, P., Hausherr, E., Chapuy, M. C., Marcelli, C., Grandjean, H., Muller, C., ... Delmas, P. D. (1996). Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 11(10), pp. 1531-8.
Garnero P, et al. Markers of Bone Resorption Predict Hip Fracture in Elderly Women: the EPIDOS Prospective Study. J Bone Miner Res. 1996;11(10):1531-8. PubMed PMID: 8889854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. AU - Garnero,P, AU - Hausherr,E, AU - Chapuy,M C, AU - Marcelli,C, AU - Grandjean,H, AU - Muller,C, AU - Cormier,C, AU - Bréart,G, AU - Meunier,P J, AU - Delmas,P D, PY - 1996/10/1/pubmed PY - 1996/10/1/medline PY - 1996/10/1/entrez SP - 1531 EP - 8 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 - 11 IS - 10 N2 - Increased bone turnover has been suggested as a potential risk factor for osteoporotic fractures. We investigated this hypothesis in a prospective cohort study performed on 7598 healthy women more than 75 years of age. One hundred and twenty-six women (mean years 82.5) who sustained a hip fracture during a mean 22-month follow-up were age-matched with three controls who did not fracture. Baseline samples were collected prior to fracture for the measurement of two markers of bone formation and three urinary markers of bone resorption: type I collagen cross-linked N- (NTX) or C-telopeptide (CTX) and free deoxypyridinoline (free D-Pyr). Elderly women had increased bone formation and resorption compared with healthy premenopausal women. Urinary excretion of CTX and free D-Pyr, but not other markers, was higher in patients with hip fracture than in age-matched controls (p = 0.02 and 0.005, respectively). CTX and free D-Pyr excretion above the upper limit of the premenopausal range was associated with an increased hip fracture risk with an odds ratio (95% confidence interval) of 2.2 (1.3-3.6) and 1.9 (1.1-3.2), respectively, while markers of formation were not. Increased bone resorption predicted hip fracture independently of bone mass, i.e., after adjustment for femoral neck bone mineral density (BMD) and independently of mobility status assessed by the gait speed. Women with both a femoral BMD value of 2.5 SD or more below the mean of young adults and either high CTX or high free D-Pyr levels were at greater risk of hip fracture, with an odds ratio of 4.8 and 4.1, respectively, than those with only low BMD or high bone resorption. Elderly women are characterized by increased bone turnover, and some markers of bone resorption predict the subsequent risk of hip fracture independently of hip BMD. Combining the measurement of BMD and bone resorption may be useful to improve the assessment of the risk of hip fracture in elderly women. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/8889854/Markers_of_bone_resorption_predict_hip_fracture_in_elderly_women:_the_EPIDOS_Prospective_Study_ L2 - https://doi.org/10.1002/jbmr.5650111021 DB - PRIME DP - Unbound Medicine ER -