Bone Turnover Markers and Prediction of Fracture: A Prospective Follow-Up Study of 1040 Elderly Women for a Mean of 9 Years
Bone Turnover Markers and Prediction of Fracture: A Prospective Follow-Up Study of 1040 Elderly Women for a Mean of 9 Years
复制标题
DOI：
10.1359/jbmr.091006
复制
发表时间：
2010-02-01
影响因子：
6.2
通讯作者：
Obrant, Karl J.
中科院分区：
文献类型：
--
作者：
Ivaska, Kaisa K.;Gerdhem, Paul;Obrant, Karl J.
骨质疏松症的特征是骨量和强度受损，易导致骨折风险增加。骨代谢增加被认为是骨折的危险因素。本研究的目的是评估基线骨转换标志物是否与骨折的长期发生率相关，该研究基于1040名75岁女性的人群样本（马尔莫OPRA研究）。在基线和1年随访访视时测量了7种骨标志物（S-TRACP 5 b、S-CTX-1、S-OC[1-49]、S-TotaIOC、S-cOC、S-boneALP和尿骨钙素）。在平均9.0年的随访期间（范围7.4-10.9），363名妇女至少发生了一次任何类型的骨折，包括116例髋部骨折和103例临床椎骨骨折。高S-TRACP 5 b和S-CTX-1水平与任何骨折风险增加相关，风险比[HR（95%置信区间）]分别为1.16（1.04-1.29）和1.13（1.01-1.27）/SD增加。它们还与临床椎体骨折的风险增加相关，HR分别为1.22（1.01-1.48）和1.32（1.05-1.67）。标记物与髋部骨折风险无关。当我们使用骨吸收标志物，包括尿骨钙素，在1年随访时测量或两次测量的平均值时，结果相似。任何骨折的HR在随访期开始时最高，从基线开始2.5年。对于椎骨骨折，这种关联更明显，持续时间更长，至少5年。总之，S-TRACP 5 b、S-CTX-1和尿骨钙素水平升高与老年女性骨折风险增加相关，持续时间长达10年。(C)2010年美国骨与矿物质研究学会。
Osteoporosis is characterized by compromised bone mass and strength, predisposing to an increased risk of fracture. Increased bone metabolism has been suggested to be a risk factor for fracture. The aim of this study was to evaluate whether baseline bone turnover markers are associated with long-term incidence of fracture in a population-based sample of 1040 women who were 75 years old (Malmo OPRA study). Seven bone markers (S-TRACP5b, S-CTX-1, S-OC[1-49], S-TotaIOC, S-cOC, S-boneALP, and urinary osteocalcin) were measured at baseline and 1-year follow-up visit. During the mean follow-up of 9.0 years (range 7.4-10.9), 363 women sustained at least one fracture of any type, including 116 hip fractures and 103 clinical vertebral fractures. High S-TRACP5b and S-CTX-1 levels were associated with increased risk of any fracture with hazard ratios [HRs (95% confidence interval)] of 1.16 (1.04-1.29) and 1.13 (1.01-1.27) per SD increase, respectively. They also were associated with increased risk of clinical vertebral fracture with HRs of 1.22 (1.01-1.48) and 1.32 (1.05-1.67), respectively. Markers were not associated with risk for hip fracture. Results were similar when we used resorption markers, including urinary osteocalcin, measured at the 1-year visit or an average of the two measurements. The HRs were highest for any fracture in the beginning of the follow-up period, 2.5 years from baseline. For vertebral fractures, the association was more pronounced and lasted for a longer period of time, at least for 5 years. In conclusion, elevated levels of S-TRACP5b, S-CTX-1, and urinary osteocalcin are associated with increased fracture risk for up to a decade in elderly women. (C) 2010 American Society for Bone and Mineral Research.