期刊
CALCIFIED TISSUE INTERNATIONAL
卷 111, 期 3, 页码 288-299出版社
SPRINGER
DOI: 10.1007/s00223-022-00996-8
关键词
Bone; Osteoporosis; Bone turnover markers; Fracture
资金
- University of Turku (UTU)
- Turku University Central Hospital
- Swedish Research Council [K201552X-14691-13-4]
- Forte [2007-2125]
- Region Skane Research and Development Council (ALF)
- Greta and Johan Kock Foundation
- , A. Pahlsson Foundation
- A. Osterlund Foundation
- H Jarnhardt foundation
- King Gustav V 80 year fund
- King Gustav V and Queen Victoria Foundation
- Swedish Rheumatism foundation
- Royal Physiographic Society Lund
- Skane University Hospital Research Fund
- Diabetes Research Foundation, Finland
- Instrumentarium Research Foundation, Finland
- Paivikki and Sakari Sohlberg Foundation, Finland
- Academy of Finland [325498]
- Region Stockholm
- Center for Medical Innovation (CIMED), Karolinska Institutet
- Academy of Finland (AKA) [325498, 325498] Funding Source: Academy of Finland (AKA)
This study found that CTX, urinary OC, and TRAcP5b are predictive for fracture risk within 1 to 3 years, but are less valuable in the long term or in individuals above the age of 80.
Purpose A major challenge in osteoporosis is to identify individuals at high fracture risk. We investigated six bone turnover markers (BTMs) to determine association with specific fracture types; the time-frame for risk prediction and whether these are influenced by age at assessment. Methods Population-based OPRA cohort (n = 1044) was assessed at ages 75, 80, 85 and fractures documented for up to 15 years. Six BTMs were analyzed at each time-point (N-terminal propeptide of type I collagen, PINP; total osteocalcin, OC; bone-specific alkaline phosphatase, BALP; C-terminal telopeptide of type I collagen, CTX; tartrate-resistant acid phosphatase 5b, TRAcP5b; urinary osteocalcin). Hazard ratios (HR) for any, major osteoporotic, vertebral and hip fractures were calculated as short (1, 2, 3 years) and long-term risk (5, 10, 15 years). Results At 75 year, high CTX levels were associated with an increased risk of all fractures, including major osteoporotic fractures, across most time-frames (HRs ranging: 1.28 to 2.28). PINP was not consistently associated. Urinary osteocalcin was consistently associated with elevated short-term risk (HRs ranging: 1.83-2.72). Other BTMs were directionally in accordance, though not all statistically significant. BTMs were not predictive for hip fractures. Association of all BTMs attenuated over time; at 80 year none were associated with an increased fracture risk. Conclusion CTX, urinary OC and TRAcP5b are predictive for fracture in a 1 to 3 year, perspective, whereas in the long-term or above age 80 years, BTMs appear less valuable. Resorption markers, particularly CTX, were more consistently associated with fracture risk than formation markers in the very elderly.
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