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. 2009 Dec;24(12):2032-8.
doi: 10.1359/jbmr.090526.

Biochemical markers of bone turnover, hip bone loss, and fracture in older men: the MrOS study

Douglas C Bauer  1 , Patrick Garnero, Stephanie L Harrison, Jane A Cauley, Richard Eastell, Kris E Ensrud, Eric Orwoll; Osteoporotic Fractures in Men (MrOS) Research Group
Affiliations

Biochemical markers of bone turnover, hip bone loss, and fracture in older men: the MrOS study

Douglas C Bauer et al. J Bone Miner Res. 2009 Dec.

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 degrees C, bone turnover measurements (type I collagen N-propeptide [PINP]; beta C-terminal cross-linked telopeptide of type I collagen [betaCTX]; 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 betaCTX (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.

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Figures

FIG. 1
FIG. 1
Total hip bone loss over 4.6 yr of follow-up (N = 682) by quartile of baseline bone turnover marker, adjusted for age and clinic. For each marker, P trend <0.01.
FIG. 2
FIG. 2
Risk of nonspine fracture over 5 yr of follow-up (N = 431) by quartile of baseline bone turnover marker, adjusted for age and clinic.
FIG. 3
FIG. 3
Risk of hip fracture over 5 yr of follow-up (N = 72) by quartile of baseline bone turnover marker, adjusted for age and clinic.
See this image and copyright information in PMC

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