Interest of biochemical markers of bone turnover for long-term prediction of new vertebral fracture in postmenopausal osteoporotic women

• Published in: Maturitas Vol. 44; no. 4; pp. 259 - 265
• Main Authors: Bruyere, Olivier, Collette, Julien, Delmas, Pierre, Rouillon, Alain, Roux, Christian, Seidel, Laurence, Richy, Florent, Reginster, Jean-Yves
• Format: Journal Article Web Resource
• Language: English
• Published: Shannon Elsevier Ireland Ltd 25-04-2003; Elsevier Science; Elsevier Sci Ireland Ltd
• Subjects: Aged; Aged, 80 and over; Alkaline Phosphatase - blood; Biological and medical sciences; Biomarkers - analysis; Bone Density; Bone mineral density; Bone Remodeling; Bone turnover markers; Collagen - urine; Collagen Type I; Creatinine - urine; Diseases of the osteoarticular system; Female; Fractures, Spontaneous - etiology; Geriatrics; Gériatrie; Human health sciences; Humans; Medical sciences; Middle Aged; Médecine de la reproduction (Gynécologie, andrologie, obstétrique); Osteocalcin - blood; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - metabolism; Osteoporosis. Osteomalacia. Paget disease; Peptides - urine; Reproductive medicine (gynecology, andrology, obstetrics); Risk Factors; Sciences de la santé humaine; Sciences sociales & comportementales, psychologie; Social & behavioral sciences, psychology; Sociologie & sciences sociales; Sociology & social sciences; Spinal Fractures - etiology; Vertebral fracture; Vertebral fracture; Osteoporosis; Bone mineral density; Bone turnover markers; Alkaline phosphatase; Biological fluid; Prognosis; Diseases of the osteoarticular system; Phosphoric monoester hydrolases; Biological marker; Vertebra; Esterases; Bone disease; Fracture; Spine disease; Creatine; Collagen type I; Postmenopause; Female; Serum; Human; Urine; Osteocalcin; Enzyme; Trauma; Long term; Hydrolases; Predictive factor
• ISSN: 0378-5122; 1873-4111; 1873-4111
• DOI: 10.1016/S0378-5122(03)00042-2

Objective: To analyse the interest of baseline levels and short-term (3-months) changes in serum osteocalcin (BGP), serum bone-specific alkaline phosphatase (BALP) and urinary C-telopeptide of type I collagen/creatinine ratio (U-CTX) to predict 3-years changes in bone mineral density (BMD) and spinal deformity index (SDI) in postmenopausal osteoporotic women.
Methods: Data were derived from a cohort of 603 osteoporotic women corresponding to the placebo arm of a 3-years prospective, double-blind study.
Results: Baseline values of BALP, BGP and U-CTX were negatively and significantly correlated with baseline spinal BMD. Significant correlations were also observed between the changes in BMD observed after 36 months at the spine and baseline BALP (
r=0.20,
P=0.0001), BGP (
r=0.09,
P=0.05) and U-CTX (
r=−0.11,
P=0.02). At 3 years, 71 women (15.9%) showed an increase in their SDI, corresponding to the occurrence of at least one new vertebral deformity. Baseline values of the four bone turnover markers (BTM) were not significantly related to the occurrence of new vertebral deformities. However, when considering the changes in the BTM observed after 3-months of follow-up, BGP (
P=0.003) and U-CTX (
P=0.047) were identified as significant predictors of an increase of SDI. The associated odds ratios (95% confidence interval (CI)) were 10.922 (2.218–53.78) for unit changes of log BGP and 1.369 (1.003–1.867) for unit changes of log
U-CTX. The relative risk (RR) (IC 95%) of having a new vertebral fracture over 36 months was 0.31 (0.15–0.65) when being in the lowest quartile of 3-months changes in BGP as compared with the highest.
Conclusion: We conclude that two sequential measurements of BGP and U-CTX performed at 3-months intervals could be of interest to identify postmenopausal osteoporotic women with the highest risk to present new vertebral deformities.