Association between bone turnover rate and bone microarchitecture in men: The STRAMBO study

Abstract

Few data concern the relationship between bone turnover and microarchitecture in men. We investigated the association between levels of biochemical markers of bone turnover (BTM) and bone microarchitecture in 1149 men aged 19 to 85 years. Bone microarchitecture was assessed by high-resolution peripheral quantitative computed tomography at the distal radius and tibia. Bone formation was assessed by serum osteocalcin, bone alkaline phosphatase, and N-terminal extension propeptide of type I collagen. Bone resorption was assessed by serum C-terminal telopeptide of type I collagen and urinary excretion of total deoxypyridinoline. BTM levels were high in young men and decreased until age 50 years. Urinary deoxypyridinoline (DPD) increased after age 70 years, whereas other BTMs remained stable. Before 50 years of age, only cortical volumetric bone mineral density (D cort ) correlated negatively with BTM levels. Between 50 and 70 years of age, D cort and some microarchitectural parameters correlated significantly with BTM at the radius and tibia. After 70 years of age, higher BTM levels were associated with lower cortical thickness and D cort at both the skeletal sites. At the distal radius, men in the highest BTM quartile had lower trabecular density, number (Tb.N), and thickness (Tb.Th) and more heterogeneous trabecular distribution compared with men in the lower quartiles. At the distal tibia, higher BTM levels were associated with lower Tb.N and Tb.Th in the central but not subendocortical area. Thus, in men, bone microarchitecture depends weakly on the current bone turnover rate until age 70. Thereafter, bone turnover seems to be a significant determinant of bone microarchitecture. ß

Association of bone microarchitecture with parathyroid hormone concentration and calcium intake in men: the STRAMBO study

“…The inverse associations of PTH level with Ct.Th at the distal tibia and with Tb.N at the distal radius suggest that higher bone resorption triggers this process. Positive association between the levels of PTH and BTM in this study and poor bone microarchitecture in men with high bone turnover found previously show that secondary hyperparathyroidism may stimulate bone turnover and contribute to the deterioration of bone microarchitecture (14). At the distal tibia, Ct.Th decreased and Ma.Ar increased, whereas Tt.Ar did not vary across the PTH quartiles.…”

“…The STRAMBO study is a single-center prospective cohort study of skeletal fragility and its determinants in men (14). It is a collaboration between National Institute of Health and Medical Research (INSERM) and Mutuelle de la Région Lyonnaise (MTRL).…”

“…Accelerated bone turnover was associated with impaired bone microarchitecture in men, mainly after 70 years (14). However, association of bone microarchitecture with concentrations of PTH and 25OHD is poorly studied (15).…”

Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in men

“…The Structure of the Aging Men's Bones (STRAMBO) study is a single-center prospective cohort study of the skeletal fragility and its determinants in 1169 men aged 20 to 85 years, which has already been described in a previous publication (20) and has been approved by an independent ethical committee. Briefly, all participants replied to an epidemiological questionnaire that was administered by an interviewer and covered lifestyle factors and health status.…”

“…No specific exclusion criteria were used. (20) The present analysis was carried out in a subset of 370 men from the STRAMBO cohort: 185 men (mean age, 71 AE 10 years) with a history of fragility fractures and 185 healthy controls without history of fracture, randomly matched for age, height, and weight. Both groups underwent measurement of density and microarchitecture at the distal radius and tibia at the baseline visit.…”