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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
Author(s) -
Ivaska Kaisa K,
Gerdhem Paul,
Väänänen H Kalervo,
Åkesson Kristina,
Obrant Karl J
Publication year - 2010
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.091006
Subject(s) - medicine , bone remodeling , osteoporosis , hip fracture , hazard ratio , confidence interval , prospective cohort study , osteocalcin , risk factor , population , bone resorption , odds ratio , surgery , biology , alkaline phosphatase , environmental health , enzyme , biochemistry
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. © 2010 American Society for Bone and Mineral Research