Serial assessment of serum bone metabolism markers identifies women with the highest rate of bone loss and osteoporosis risk
Serial assessment of serum bone metabolism markers identifies women with the highest rate of bone loss and osteoporosis risk
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DOI：
10.1210/jc.2007-1508
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发表时间：
2008-07-01
影响因子：
5.8
通讯作者：
Obrant, Karl J.
中科院分区：
文献类型：
--
作者：
Ivaska, Kaisa K.;Lenora, Janaka;Obrant, Karl J.
内容：在骨质疏松症的管理中的一个重要挑战是确定妇女谁是在高风险的发展骨质疏松症和脆性fractions.Objective：我们的目的是评估是否骨代谢的评估在多个场合可以确定妇女的骨loss.Design的风险最高：马尔莫骨质疏松症的前瞻性风险评估研究是一项正在进行的纵向研究。参与者进行了评估，在基线和1，3，和5 yr.Setting：我们进行了一项基于人口的study.Participants：参与者包括1044名妇女，所有75岁的baseline.Main Outcome Measures：7骨转换标志物进行了评估，在基线和1，3，和5 yr（n = 573）。5年的变化，面积骨密度（aBMD）也determined.Results：基线标志物相关性弱全身aBMD的变化。当使用基线和1年测量值的平均值时，这种关联更加明显（标准化回归系数-0.12至-0.23，P < 0.01）。将3年和5年测量值相加进一步加强了相关性（回归系数达-0.30，P < 0.001）。在全身评估中，持续高周转率的女性（-2.6%）比中等（-1.6%）或低周转率的女性（-0.2%，P < 0.001）丢失更多的骨。他们的髋部BMD也有更大的下降（分别为-8.3%，-6.0%和-5.1%，P = 0.010）。结果也是相似的亚组的妇女与osteopeny.Conclusions：我们的研究结果表明，骨转换系列评估提高了妇女的骨丢失率和骨质疏松症的风险最高的识别。
Context: One of the important challenges in the management of osteoporosis is to identify women who are at high risk of developing osteoporosis and fragility fractures.Objective: Our objective was to evaluate whether assessment of bone metabolism at multiple occasions can identify women with the highest risk for bone loss.Design: The Malmo Osteoporosis Prospective Risk Assessment study is an ongoing longitudinal study. Participants have been evaluated at baseline and after 1, 3, and 5 yr.Setting: We conducted a population-based study.Participants: Participants included 1044 women, all 75 yr old at baseline.Main Outcome Measures: Seven bone turnover markers were assessed at baseline and at 1, 3, and 5 yr (n = 573). The 5-yr change in areal bone mineral density (aBMD) was also determined.Results: Baseline markers correlated weakly to change in total body aBMD. The associations were more pronounced when the average of the baseline and 1-yr measurements was used (standardized regression coefficients -0.12 to -0.23, P < 0.01). Adding the 3-yr and 5-yr measurement further strengthened the correlation (regression coefficients up to -0.30, P < 0.001). Women with constantly high turnover lost significantly more bone at total body assessment (-2.6%) than women with intermediate (-1.6%) or low turnover (-0.2%, P for trend < 0.001). They also had a greater decrease in hip BMD (-8.3, -6.0, and -5.1%, respectively, P = 0.010). Results were similar also in the subgroup of women with osteopenia.Conclusions: Our results suggest that serial assessment of bone turnover improves the identification of women with the highest rate of bone loss and osteoporosis risk.