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Relationship of bone turnover to bone density and fractures.
J Bone Miner Res. 1997 Jul; 12(7):1083-91.JB

Abstract

To assess the influence of bone turnover on bone density and fracture risk, we measured serum levels of osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal propeptide of type I procollagen (PICP), as well as 24-h urine levels of cross-linked N-telopeptides of type I collagen (NTx) and the free pyridinium cross-links, pyridinoline (Pyd) and deoxypyridinoline (Dpd), among 351 subjects recruited from an age-stratified random sample of Rochester, Minnesota women, PICP, NTx, and Dpd were negatively associated with age among the 138 premenopausal women. All of the biochemical markers were positively associated with age among the 213 postmenopausal women, and the prevalence of elevated turnover (> 1 standard deviation [SD] above the premenopausal mean) varied from 9% (PICP) to 42% (Pyd). After adjusting for age, most of the markers were negatively correlated with bone mineral density (BMD) of the hip, spine, or forearm as measured by dual-energy X-ray absorptiometry, and women with osteoporosis were more likely to have high bone turnover. A history of osteoporotic fractures of the hip, spine, or distal forearm was associated with reduced hip BMD and with elevated Pyd. After adjusting for lower BMD and increased bone resorption, reduced bone formation as assessed by OC was also associated with prior osteoporotic fractures. These data indicate that a substantial subset of elderly women has elevated bone turnover, which appears to adversely influence BMD and fracture risk. Combined biochemical and BMD screening may provide better prediction of future fracture risk than BMD alone.

Authors+Show Affiliations

Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9200008

Citation

Melton, L J., et al. "Relationship of Bone Turnover to Bone Density and Fractures." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 12, no. 7, 1997, pp. 1083-91.
Melton LJ, Khosla S, Atkinson EJ, et al. Relationship of bone turnover to bone density and fractures. J Bone Miner Res. 1997;12(7):1083-91.
Melton, L. J., Khosla, S., Atkinson, E. J., O'Fallon, W. M., & Riggs, B. L. (1997). Relationship of bone turnover to bone density and fractures. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 12(7), 1083-91.
Melton LJ, et al. Relationship of Bone Turnover to Bone Density and Fractures. J Bone Miner Res. 1997;12(7):1083-91. PubMed PMID: 9200008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of bone turnover to bone density and fractures. AU - Melton,L J,3rd AU - Khosla,S, AU - Atkinson,E J, AU - O'Fallon,W M, AU - Riggs,B L, PY - 1997/7/1/pubmed PY - 2001/3/28/medline PY - 1997/7/1/entrez SP - 1083 EP - 91 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 - 12 IS - 7 N2 - To assess the influence of bone turnover on bone density and fracture risk, we measured serum levels of osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal propeptide of type I procollagen (PICP), as well as 24-h urine levels of cross-linked N-telopeptides of type I collagen (NTx) and the free pyridinium cross-links, pyridinoline (Pyd) and deoxypyridinoline (Dpd), among 351 subjects recruited from an age-stratified random sample of Rochester, Minnesota women, PICP, NTx, and Dpd were negatively associated with age among the 138 premenopausal women. All of the biochemical markers were positively associated with age among the 213 postmenopausal women, and the prevalence of elevated turnover (> 1 standard deviation [SD] above the premenopausal mean) varied from 9% (PICP) to 42% (Pyd). After adjusting for age, most of the markers were negatively correlated with bone mineral density (BMD) of the hip, spine, or forearm as measured by dual-energy X-ray absorptiometry, and women with osteoporosis were more likely to have high bone turnover. A history of osteoporotic fractures of the hip, spine, or distal forearm was associated with reduced hip BMD and with elevated Pyd. After adjusting for lower BMD and increased bone resorption, reduced bone formation as assessed by OC was also associated with prior osteoporotic fractures. These data indicate that a substantial subset of elderly women has elevated bone turnover, which appears to adversely influence BMD and fracture risk. Combined biochemical and BMD screening may provide better prediction of future fracture risk than BMD alone. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/9200008/Relationship_of_bone_turnover_to_bone_density_and_fractures_ L2 - https://doi.org/10.1359/jbmr.1997.12.7.1083 DB - PRIME DP - Unbound Medicine ER -