Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov 25;14(11):e0225539.
doi: 10.1371/journal.pone.0225539. eCollection 2019.

Smoking and other determinants of bone turnover

Rolf Jorde  1   2 , Astrid Kamilla Stunes  3   4 , Julia Kubiak  1 , Guri Grimnes  1   2 , Per Medbøe Thorsby  5 , Unni Syversen  3   6
Affiliations

Smoking and other determinants of bone turnover

Rolf Jorde et al. PLoS One. .

Abstract

The balance between bone resorption and formation may be assessed by measurement of bone turnover markers (BTMs), like carboxyl-terminal cross-linked telopeptide of type 1 collagen (CTX-1) and procollagen type 1 amino-terminal propeptide (P1NP). Smoking has been shown to influence bone turnover and to reduce bone mass density (BMD), the exact mechanism for this is, however, not settled. In this post-hoc study including 406 subjects (mean age 51.9 years), we aimed to study the impact of smoking on bone turnover. Moreover, we wanted to assess the inter-correlation between substances regulating bone metabolism and BTMs, as well as tracking over time. BMD measurements and serum analyses of CTX-1, P1NP, osteoprotegerin (OPG), receptor activator of nuclear factor ĸB ligand (RANKL), Dickkopf-1 (DKK1), sclerostin, tumor necrosis factor-α (TNF-α), and leptin were performed. Repeated serum measurements were made in 195 subjects after four months. Adjustments were made for sex, age, body mass index (BMI), smoking status, insulin resistance, serum calcium, parathyroid hormone, 25-hydroxyvitamin D and creatinine. Smokers had higher levels of DKK1 and OPG, and lower levels of RANKL, as reflected in lower BTMs and BMD compared to non-smokers. There were strong and predominantly positive inter-correlations between BTMs and the other substances, and there was a high degree of tracking with Spearman's rho from 0.72 to 0.92 (P < 0.001) between measurements four months apart. In conclusion, smokers exhibited higher levels of DKK1 and OPG and a lower bone turnover than did non-smokers. The strong inter-correlations between the serum parameters illustrate the coupling between bone resorption and formation and crosstalk between cells.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Relation between the serum CTX-1 and P1NP in the 406 subjects.
Fig 2
Fig 2. Relation between P1PN and BMD total hip in the 406 subjects.
Fig 3
Fig 3. Relation between sclerostin and BMD total hip in the 406 subjects.
Fig 4
Fig 4. Relation between serum CTX-1 at baseline and after four months in the 195 subjects in the placebo group in the intervention study.
Fig 5
Fig 5. Relation between serum P1NP at baseline and after four months in the 195 subjects in the placebo group in the intervention study.
See this image and copyright information in PMC

References

    1. Tanaka Y, Nakayamada S, Okada Y. Osteoblasts and osteoclasts in bone remodeling and inflammation. Curr Drug Targets Inflamm Allergy. 2005; 4:325–8. 10.2174/1568010054022015 - DOI - PubMed
    1. Ikeda K, Takeshita S. Factors and mechanisms involved in the coupling from bone resorption to formation: how osteoclasts talk to osteoblasts. J Bone Metab. 2014; A21(3):163–7. - PMC - PubMed
    1. Eastell R, Pigott T, Gossiel F, Naylor KE, Walsh JS, Peel NFA. DIAGNOSIS OF ENDOCRINE DISEASE: Bone turnover markers: are they clinically useful? Eur J Endocrinol. 2018; 178:R19–R31. 10.1530/EJE-17-0585 - DOI - PubMed
    1. Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011; 22:391–420. 10.1007/s00198-010-1501-1 - DOI - PubMed
    1. Martin TJ, Sims NA. RANKL/OPG; Critical role in bone physiology. Rev Endocr Metab Disord. 2015; 16:131–9. 10.1007/s11154-014-9308-6 - DOI - PubMed

Publication types

LinkOut - more resources