Biochemical Markers of Bone Turnover and Prediction of Hip Bone Loss in Older Women: The Study of Osteoporotic Fractures

Oxford University Press (OUP) - Tập 14 Số 8 - Trang 1404-1410 - 1999
Douglas C. Bauer1,2, Peter M. Sklarin2, Katie Stone1, Dennis M. Black1, Michael C. Nevitt1, Kristine E. Ensrud3, Claude D. Arnaud2, Harry K. Genant1,2,4, Patrick Garnero5, P. D. Delmas5, Henrik Lawaetz6, S. R. Cummings1,2
1Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, U.S.A.
2Department of Medicine University of California, San Francisco, San Francisco, California U.S.A.
3Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, U.S.A., and Section of General Internal Medicine, Minneapolis VAMC, Minneapolis, Minnesota, U.S.A.
4Department of Radiology, University of California–San Francisco, San Francisco, California, U.S.A.
5INSERM Unit 403, Hopital E. Herriot, Lyon, France
6Center for Clinical and Basic Research, Ballerup, Denmark

Tóm tắt

Abstract To examine the ability of commercially available biochemical markers of bone formation and resorption to predict hip bone loss, we prospectively obtained serum and timed 2-h urine specimens from 295 women age 67 years or older who were not receiving estrogen replacement therapy. Serum was assayed for two markers of bone formation: osteocalcin (OC) and bone-specific alkaline phosphatase (BALP). Urine specimens were assayed for four markers of bone resorption: N-telopeptides (NTX), free pyridinolines (Pyr), free deoxypyridinoline (Dpyr), and C-telopeptides (CTX). Measurements of hip bone mineral density were made at the time the samples were collected and then repeated an average of 3.8 years later. Higher levels of all four resorption markers were, on average, significantly associated with faster rates of bone loss at the total hip, but not at the femoral neck. Women with OC levels above the median had a significantly faster rate of bone loss than women with levels below the median, but there was no significant association between levels of BALP and hip bone loss. The sensitivity and specificity of higher marker levels for predicting rapid hip bone loss was limited, and there was considerable overlap in bone loss rates between women with high and low marker levels. We conclude that higher levels of urine NTX, CTX, Pyr, Dpyr, and serum OC are associated with faster bone loss at the hip in this population of elderly women not receiving estrogen replacement therapy, but these biochemical markers have limited value for predicting rapid hip bone loss in individuals.

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Oxford University Press (OUP)

Tập 14 Số 8

1404-1410

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