Biochemical markers of bone turnover, hip bone loss, and fracture in older men

The MrOS study

Douglas C. Bauer, Patrick Garnero, Stephanie L. Harrison, Jane A. Cauley, Richard Eastell, Kris E. Ensrud, Eric Orwoll

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

We used data from the Osteoporotic Fractures in Men (MrOS) study to test the hypothesis that men with higher levels of bone turnover would have accelerated bone loss and an elevated risk of fracture. MrOS enrolled 5995 subjects >65 yr; hip BMD was measured at baseline and after a mean follow-up of 4.6 yr. Nonspine fractures were documented during a mean follow-up of 5.0 yr. Using fasting serum collected at baseline and stored at -190°C, bone turnover measurements (type I collagen N-propeptide [PINP]; β C-terminal cross-linked telopeptide of type I collagen [βCTX]; and TRACP5b) were obtained on 384 men with nonspine fracture (including 72 hip fractures) and 947 men selected at random. Among randomly selected men, total hip bone loss was 0.5%/yr among those in the highest quartile of PINP (>44.3 ng/ml) and 0.3%/yr among those in the lower three quartiles (p = 0.01). Fracture risk was elevated among men in the highest quartile of PINP (hip fracture relative hazard = 2.13; 95% CI: 1.23, 3.68; nonspine relative hazard = 1.57, 95% CI: 1.21, 2.05) or βCTX (hip fracture relative hazard = 1.76, 95 CI: 1.04, 2.98; nonspine relative hazard = 1.29, 95% CI: 0.99, 1.69) but not TRACP5b. Further adjustment for baseline hip BMD eliminated all associations between bone turnover and fracture. We conclude that higher levels of bone turnover are associated with greater hip bone loss in older men, but increased turnover is not independently associated with the risk of hip or nonspine fracture.

Original languageEnglish (US)
Pages (from-to)2032-2038
Number of pages7
JournalJournal of Bone and Mineral Research
Volume24
Issue number12
DOIs
StatePublished - Dec 2009

Fingerprint

Pelvic Bones
Bone Remodeling
Bone Fractures
Hip Fractures
Biomarkers
Hip
Collagen Type I
Osteoporotic Fractures
Fasting
Bone and Bones
Serum

Keywords

  • Bone turnover markers
  • Fracture risk
  • Men
  • Osteoporosis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Biochemical markers of bone turnover, hip bone loss, and fracture in older men : The MrOS study. / Bauer, Douglas C.; Garnero, Patrick; Harrison, Stephanie L.; Cauley, Jane A.; Eastell, Richard; Ensrud, Kris E.; Orwoll, Eric.

In: Journal of Bone and Mineral Research, Vol. 24, No. 12, 12.2009, p. 2032-2038.

Research output: Contribution to journalArticle

Bauer, Douglas C. ; Garnero, Patrick ; Harrison, Stephanie L. ; Cauley, Jane A. ; Eastell, Richard ; Ensrud, Kris E. ; Orwoll, Eric. / Biochemical markers of bone turnover, hip bone loss, and fracture in older men : The MrOS study. In: Journal of Bone and Mineral Research. 2009 ; Vol. 24, No. 12. pp. 2032-2038.
@article{fb443d675fcc48bbb2ebcfc089cb8b71,
title = "Biochemical markers of bone turnover, hip bone loss, and fracture in older men: The MrOS study",
abstract = "We used data from the Osteoporotic Fractures in Men (MrOS) study to test the hypothesis that men with higher levels of bone turnover would have accelerated bone loss and an elevated risk of fracture. MrOS enrolled 5995 subjects >65 yr; hip BMD was measured at baseline and after a mean follow-up of 4.6 yr. Nonspine fractures were documented during a mean follow-up of 5.0 yr. Using fasting serum collected at baseline and stored at -190°C, bone turnover measurements (type I collagen N-propeptide [PINP]; β C-terminal cross-linked telopeptide of type I collagen [βCTX]; and TRACP5b) were obtained on 384 men with nonspine fracture (including 72 hip fractures) and 947 men selected at random. Among randomly selected men, total hip bone loss was 0.5{\%}/yr among those in the highest quartile of PINP (>44.3 ng/ml) and 0.3{\%}/yr among those in the lower three quartiles (p = 0.01). Fracture risk was elevated among men in the highest quartile of PINP (hip fracture relative hazard = 2.13; 95{\%} CI: 1.23, 3.68; nonspine relative hazard = 1.57, 95{\%} CI: 1.21, 2.05) or βCTX (hip fracture relative hazard = 1.76, 95 CI: 1.04, 2.98; nonspine relative hazard = 1.29, 95{\%} CI: 0.99, 1.69) but not TRACP5b. Further adjustment for baseline hip BMD eliminated all associations between bone turnover and fracture. We conclude that higher levels of bone turnover are associated with greater hip bone loss in older men, but increased turnover is not independently associated with the risk of hip or nonspine fracture.",
keywords = "Bone turnover markers, Fracture risk, Men, Osteoporosis",
author = "Bauer, {Douglas C.} and Patrick Garnero and Harrison, {Stephanie L.} and Cauley, {Jane A.} and Richard Eastell and Ensrud, {Kris E.} and Eric Orwoll",
year = "2009",
month = "12",
doi = "10.1359/jbmr.090526",
language = "English (US)",
volume = "24",
pages = "2032--2038",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Biochemical markers of bone turnover, hip bone loss, and fracture in older men

T2 - The MrOS study

AU - Bauer, Douglas C.

AU - Garnero, Patrick

AU - Harrison, Stephanie L.

AU - Cauley, Jane A.

AU - Eastell, Richard

AU - Ensrud, Kris E.

AU - Orwoll, Eric

PY - 2009/12

Y1 - 2009/12

N2 - We used data from the Osteoporotic Fractures in Men (MrOS) study to test the hypothesis that men with higher levels of bone turnover would have accelerated bone loss and an elevated risk of fracture. MrOS enrolled 5995 subjects >65 yr; hip BMD was measured at baseline and after a mean follow-up of 4.6 yr. Nonspine fractures were documented during a mean follow-up of 5.0 yr. Using fasting serum collected at baseline and stored at -190°C, bone turnover measurements (type I collagen N-propeptide [PINP]; β C-terminal cross-linked telopeptide of type I collagen [βCTX]; and TRACP5b) were obtained on 384 men with nonspine fracture (including 72 hip fractures) and 947 men selected at random. Among randomly selected men, total hip bone loss was 0.5%/yr among those in the highest quartile of PINP (>44.3 ng/ml) and 0.3%/yr among those in the lower three quartiles (p = 0.01). Fracture risk was elevated among men in the highest quartile of PINP (hip fracture relative hazard = 2.13; 95% CI: 1.23, 3.68; nonspine relative hazard = 1.57, 95% CI: 1.21, 2.05) or βCTX (hip fracture relative hazard = 1.76, 95 CI: 1.04, 2.98; nonspine relative hazard = 1.29, 95% CI: 0.99, 1.69) but not TRACP5b. Further adjustment for baseline hip BMD eliminated all associations between bone turnover and fracture. We conclude that higher levels of bone turnover are associated with greater hip bone loss in older men, but increased turnover is not independently associated with the risk of hip or nonspine fracture.

AB - We used data from the Osteoporotic Fractures in Men (MrOS) study to test the hypothesis that men with higher levels of bone turnover would have accelerated bone loss and an elevated risk of fracture. MrOS enrolled 5995 subjects >65 yr; hip BMD was measured at baseline and after a mean follow-up of 4.6 yr. Nonspine fractures were documented during a mean follow-up of 5.0 yr. Using fasting serum collected at baseline and stored at -190°C, bone turnover measurements (type I collagen N-propeptide [PINP]; β C-terminal cross-linked telopeptide of type I collagen [βCTX]; and TRACP5b) were obtained on 384 men with nonspine fracture (including 72 hip fractures) and 947 men selected at random. Among randomly selected men, total hip bone loss was 0.5%/yr among those in the highest quartile of PINP (>44.3 ng/ml) and 0.3%/yr among those in the lower three quartiles (p = 0.01). Fracture risk was elevated among men in the highest quartile of PINP (hip fracture relative hazard = 2.13; 95% CI: 1.23, 3.68; nonspine relative hazard = 1.57, 95% CI: 1.21, 2.05) or βCTX (hip fracture relative hazard = 1.76, 95 CI: 1.04, 2.98; nonspine relative hazard = 1.29, 95% CI: 0.99, 1.69) but not TRACP5b. Further adjustment for baseline hip BMD eliminated all associations between bone turnover and fracture. We conclude that higher levels of bone turnover are associated with greater hip bone loss in older men, but increased turnover is not independently associated with the risk of hip or nonspine fracture.

KW - Bone turnover markers

KW - Fracture risk

KW - Men

KW - Osteoporosis

UR - http://www.scopus.com/inward/record.url?scp=73849146589&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73849146589&partnerID=8YFLogxK

U2 - 10.1359/jbmr.090526

DO - 10.1359/jbmr.090526

M3 - Article

VL - 24

SP - 2032

EP - 2038

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 12

ER -