Bone Turnover Marker Profiling and Fracture Risk in Older Women : Fracture Risk from Age 75 to 90
Ivaska, Kaisa K. LU ; McGuigan, Fiona E. LU
; Malmgren, Linnea
LU
; Gerdhem, Paul
LU
; Johansson, Helena
; Kanis, John A.
and Akesson, Kristina E.
LU
(2022)
In Calcified Tissue International
111(3).
p.288-299
- Abstract
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... (More)
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.
(Less)
- author
- Ivaska, Kaisa K.
LU
; McGuigan, Fiona E.
LU
; Malmgren, Linnea
LU
; Gerdhem, Paul
LU
; Johansson, Helena
; Kanis, John A.
and Akesson, Kristina E.
LU
- organization
- publishing date
- 2022-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Bone, Bone turnover markers, Fracture, Osteoporosis
- in
- Calcified Tissue International
- volume
- 111
- issue
- 3
- pages
- 12 pages
- publisher
- Springer
- external identifiers
-
- pmid:35750934
- scopus:85132753152
- ISSN
- 0171-967X
- DOI
- 10.1007/s00223-022-00996-8
- language
- English
- LU publication?
- yes
- id
- 9d6b318d-f607-4e69-b372-0d8f63c34502
- date added to LUP
- 2022-09-23 13:07:42
- date last changed
- 2024-04-15 18:58:52
@article{9d6b318d-f607-4e69-b372-0d8f63c34502,
abstract = {{<p>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.</p>}},
author = {{Ivaska, Kaisa K. and McGuigan, Fiona E. and Malmgren, Linnea and Gerdhem, Paul and Johansson, Helena and Kanis, John A. and Akesson, Kristina E.}},
issn = {{0171-967X}},
keywords = {{Bone; Bone turnover markers; Fracture; Osteoporosis}},
language = {{eng}},
number = {{3}},
pages = {{288--299}},
publisher = {{Springer}},
series = {{Calcified Tissue International}},
title = {{Bone Turnover Marker Profiling and Fracture Risk in Older Women : Fracture Risk from Age 75 to 90}},
url = {{http://dx.doi.org/10.1007/s00223-022-00996-8}},
doi = {{10.1007/s00223-022-00996-8}},
volume = {{111}},
year = {{2022}},
}