Case-control analysis of bone resorption markers, disability, and hip fracture risk: the Rotterdam study

Daele, P. L. A. Van; Seibel, Markus J.; Burger, Huibert; Hofman, Albert; Grobbee, Diederick E.; Leeuwen, Johannes P. T. M. van; Birkenhäger, J. C.; Pols, H.A.P.

doi:10.1136/bmj.312.7029.482

Cited by 187 publications

(110 citation statements)

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“…The value of biochemical markers of bone resorption as predictors of further occurrence of fractures is based on the hypothesis that women with the highest rate of bone turnover will experience faster loss of bone and will develop subsequent fractures. This was confirmed by prospective studies showing that markers of resorption could predict the risk of hip fractures independently of BMD [18,22]. In this perspective, the optimal marker would be the one offering the best discrimination between osteoporotic subjects and age-matched normal subjects.…”

Section: Discussionmentioning

confidence: 74%

“…These markers have been extensively used for both the assessment of therapeutic efficacy of antiresorptive drugs in osteoporosis and for prediction of fracture risk in postmenopausal women [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. We measured urinary and serum CTx and urinary NTx in a large cohort of untreated, healthy women stratified on the basis of their menopausal status and BMD.…”

Section: Discussionmentioning

confidence: 99%

“…Bone markers might also be used to prognose a high rate of bone less in postmenopausal women who would subsequently develop osteoporosis and fractures [16][17][18][19][20][21][22][23][24][25]. Bone turnover increases after menopause and remains elevated in late postmenopausal women.…”

Section: Abstract: Osteoporosis -Biochemical Markers -Bone Turnover mentioning

confidence: 99%

“…Thus, biochemical markers of bone turnover provide a rapid assessment of the effects of antiresorptive therapies such as hormone replacement therapy, bisphosphonates, and calcitonin which induce a decrease in the levels of bone markers that is correlated with the long-term effect of such treatments on bone mass [5][6][7][8][9][10][11][12][13][14][15]. Due to the small annual changes in BMD, the effect of antiresorptive therapy can only be reliably monitored by BMD measurement after several years followup [5,10,13].Bone markers might also be used to prognose a high rate of bone less in postmenopausal women who would subsequently develop osteoporosis and fractures [16][17][18][19][20][21][22][23][24][25]. Bone turnover increases after menopause and remains elevated in late postmenopausal women.…”

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confidence: 99%

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Bone Resorption in Post-menopausal Women with Normal and Low BMD Assessed with Biochemical Markers Specific for Telopeptide Derived Degradation Products of Collagen Type I

Reginster¹,

Henrotin

Christiansen

et al. 2001

Calcif Tissue Int

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Abstract. Biochemical markers of bone resorption can be used clinically to predict the risk of osteoporosis-related fractures (prognostic tool) and to assess the response of an osteoporotic patient to an antiresorptive therapy (monitoring tool). Our aim was to assess the ability of four currently marketed biochemical markers of bone resorption, based on the measurement of degradation products from collage type I telopeptides to monitor the elevated resorption associated with menopause. Women (846) were stratified for menopause, age, and bone mineral density and the following markers were measured: urinary cross-linked Ntelopeptides of type I collagen (NTx), the levels of breakdown products of type I collagen C-telopeptides in serum (S-CTx), and in urine, by ELISA (U-CTx-E), and RIA (UCTx-R). Furthermore, the ratio (␣/␤) between the ␣L form of CTx measured in the CTx RIA and the ␤L form measured in the ELISA was calculated. The mean difference was calculated for each marker in women with osteopenia (Op) or osteoporosis (PMO) (WHO definition) compared with healthy premenopausal (Pre) women and postmenopausal (N Post) women with normal bone mass. Serum CTx showed the highest elevation in post-compared with premenopausal women. All marker values were significantly higher in Op and PMO subjects compared with both Pre and to N Post women. Compared with premenopausal values, the largest elevation in both Op and PMO women was observed for serum CTx. Compared with N Post, urine NTx showed the highest increase in OP subjects. The ␣/␤ CTx ratio was elevated in post-compared with Pre women, but there was no difference in the ratio among N Post, Op, or PMO women. In conclusion, postmenopausal women showed elevated turnover with all bone resorption markers, but with substantial individual variation in resorption levels. Furthermore, the turnover process in postmenopausal women appears to be quantitatively different from the premenopausal stage, apparent as altered ␣/␤ CTx ratios. Key words: Osteoporosis -Biochemical markers -Bone turnover -Collagen type I -Antiresorptive therapiesDiagnosis.Assessment of bone physiology has been greatly improved by the development of specific and sensitive markers of bone remodeling [1,2]. Biochemical markers have advantages because they are noninvasive, inexpensive, reflect turnover in the whole skeleton, and allow repeated evaluation [3,4]. Furthermore, biochemical markers of bone remodeling are a valuable supplement to bone mineral density measurement (BMD), as they provide a dynamic measure of the current bone turnover state compared with the static measure of skeletal status provided by BMD. Thus, biochemical markers of bone turnover provide a rapid assessment of the effects of antiresorptive therapies such as hormone replacement therapy, bisphosphonates, and calcitonin which induce a decrease in the levels of bone markers that is correlated with the long-term effect of such treatments on bone mass [5][6][7][8][9][10][11][12][13][14][15]. Due to the small annual changes in BMD, the effect...

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Abstract: Osteoporosis -Biochemical Markers -Bone Turnover mentioning

confidence: 99%

mentioning

confidence: 99%

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Bone Resorption in Post-menopausal Women with Normal and Low BMD Assessed with Biochemical Markers Specific for Telopeptide Derived Degradation Products of Collagen Type I

Reginster¹,

Henrotin

Christiansen

et al. 2001

Calcif Tissue Int

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“…Biochemical markers of bone turnover have been used for prediction of fracture, by us and by others [9][10][11][12][13][14][15][16][17][18][19]. If baseline levels of these markers would be influenced in either direction by recently or non-recently sustained fracture, such an event would introduce a possible bias, to be controlled for in further studies on prediction of fracture by biochemical markers.…”

Section: Introductionmentioning

confidence: 99%