Bone turnover markers and prediction of fracture: A prospective follow-up study of 1040 elderly women for a mean of 9 years

Ivaska, Kaisa K.; Gerdhem, Paul; Väänänen, H. Kalervo; Åkesson, Kristina; Obrant, Karl

doi:10.1359/jbmr.091006

Cited by 133 publications

(103 citation statements)

References 30 publications

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“…Furthermore, our observations of BTMs in relation to the prediction of ORFs are consistent with the recent study of Ivaska and colleagues, (26) who demonstrated that only BRMs (namely serum tartrate-resistant acid phosphatase active isoform 5b [s-TRACP-5b], s-CTx, and urinary OC) were associated with increased fracture risk for up to a decade in elderly women with no association of BFMs with fracture prediction.…”

Section: Discussionsupporting

confidence: 92%

High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: The center of excellence for osteoporosis research study

Ardawi

Rouzi

Al-Sibiani

et al. 2012

Journal of Bone and Mineral Research

129

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Sclerostin regulates bone formation by inhibiting Wnt pathway signaling. Low circulating sclerostin levels cause high bone mass. We hypothesized that postmenopausal women with increased sclerostin levels have a greater risk for osteoporosis-related fractures. We examined the association between circulating sclerostin together with bone turnover markers and osteoporosis-related fracture risk in 707 postmenopausal women, in a population-based study with a mean follow-up period of 5.2 AE 1.3 years. Multivariate Cox proportional hazards regression models were used to analyze fracture risk, adjusted for age, body mass index, and other confounding risk factors. High sclerostin levels were strongly associated with increased fracture risk. After adjustment for age and other confounders, the relative fracture risk was more than sevenfold among postmenopausal women for each 1-SD increment increase in sclerostin level. Women in the highest quartile of sclerostin levels had about a 15-fold increase in fracture risk. Results were similar when we compared sclerostin at the 1-year visit to an average of two to three annual measurements. Fracture risk attributable to sclerostin levels was 56.6% in the highest quartile. Only high levels of bone resorption markers (plasma cross-linked C-terminal telopeptide of type 1 collagen [p-CTx], urinary CTx [u-CTx], and urinary N-telopeptide of type 1 collagen [u-NTx]) were predictive of osteoporosis-related fractures but at much lower hazard ratio (HR) values than that of serum sclerostin. Associations between sclerostin levels and fracture risk were independent of bone mineral density and other confounding risk factors. High sclerostin levels are a strong and independent risk factor for osteoporosis-related fractures among postmenopausal women. ß

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Section: Discussionsupporting

confidence: 92%

High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: The center of excellence for osteoporosis research study

Ardawi

Rouzi

Al-Sibiani

et al. 2012

Journal of Bone and Mineral Research

129

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“…36 There are modest but significant associations of BTM with fracture in women and men. [43][44][45][46] Still, there have been uncertainties over the use of BTM in routine clinical practice to assess fracture risk because of inter-and intra-individual variability. 47,48 Although a recent study suggested that BTM also reflect cortical bone architecture in addition to fracture risk, 31 further studies are needed to evaluate the independent role of BTM in fracture risk prediction.…”

Section: Bone Turnover Markers Cortical Porosity and Fracturementioning

confidence: 99%

The clinical contribution of cortical porosity to fragility fractures

Bjørnerem

2016

BoneKEy Reports

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Cortical bone is not compact; rather it is penetrated by many Haversian and Volkmann canals for blood supply. The lining of these canals are the intracortical bone surfaces available for bone remodeling. Increasing intracortical bone remodeling increases cortical porosity. However, cortical bone loss occurs more slowly than trabecular loss due to the fact that less surface per unit of bone matrix volume is available for bone remodeling. Nevertheless, most of the bone loss over time is cortical because cortical bone constitutes 80% of the skeleton, and the relative proportion of trabecular bone diminishes with advancing age. Higher serum levels of bone turnover markers are associated with higher cortical porosity of the distal tibia and the proximal femur. Greater porosity of the distal radius is associated with higher odds for forearm fracture, and greater porosity of the proximal femur is associated with higher odds for non-vertebral fracture in postmenopausal women. Measurement of cortical porosity contributes to fracture risk independent of areal bone mineral density and Fracture Risk Assessment Tool. On the other hand, antiresorptive treatment reduces porosity at the distal radius and at the proximal femoral shaft. Thus, porosity is a substantial determinant of the bone fragility that underlies the risk of fractures and may be a target for fracture prevention.

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“…Incident fractures during the follow--up period (until November 2006) were recorded and verified by review of the related medical records [17]. In this report, clinical symptomatic vertebral fractures from age 50 upwards were analysed.…”

Section: Dxa Measurement Visual Assessment Of Spine Degenerative Manmentioning

confidence: 99%

Variation in the PTH2R gene is associated with age-related degenerative changes in the lumbar spine

et al. 2013

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Variation in the PTH2R gene is associated with age-related degenerative changes in the lumbar spine. Link to publication Citation for published version (APA): Åkesson, K., Tenne, M., Gerdhem, P., Luthman, H., & McGuigan, F. (2015). Variation in the PTH2R gene is associated with age-related degenerative changes in the lumbar spine. Journal of Bone and Mineral Metabolism, 33(1), 9-15. DOI: 10.1007/s00774-013-0550-x General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal

show abstract

Bone turnover markers and prediction of fracture: A prospective follow-up study of 1040 elderly women for a mean of 9 years

Cited by 133 publications

References 30 publications

High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: The center of excellence for osteoporosis research study

High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: The center of excellence for osteoporosis research study

The clinical contribution of cortical porosity to fragility fractures

Variation in the PTH2R gene is associated with age-related degenerative changes in the lumbar spine

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