Declining serum bone turnover markers are associated with the short-term positive change of lumbar spine bone mineral density in postmenopausal women

Abstract

Objective: While serum bone turnover markers (BTMs) and bone mineral density (BMD) have been confirmed as useable risk assessment tools for postmenopausal osteoporosis, the associations between BTMs and BMD changes are still ambiguous. The aim of this study was to explore the underlying associations between BTMs and BMD changes in postmenopausal women. Methods: Between January 2015 and October 2020, 135 postmenopausal women were retrospectively enrolled. They were divided into two groups according to lumbar spine (LS) 1-4 BMD change (1 y T-score minus baseline T-score, Group 1 [ n = 36] < 0 and Group 2 [ n = 99] ≥ 0). The changes of BTMs (N-terminal middle segment osteocalcin [N-MID], propeptide of type I procollagen [P1NP], and β-C-terminal telopeptide of type I collagen [β-CTX]) and their associations with LS 1-4 BMD change were analyzed. The biochemical indices and clinical parameters related with LS 1-4 BMD change were also evaluated. Results: The 1 year N-MID, P1NP, β-CTX and Phosphorus in Group 2 were lower than those in Group 1 ( P < 0.05), their changes within 1 year were significantly negatively correlated with LS 1-4 BMD change ( R 2 = –0.200, P < 0.001; R 2 = –0.230, P < 0.001; R 2 = –0.186, P < 0.001; R 2 = –0.044, P = 0.015; respectively). Except for the Phosphorus change (area under the curve [AUC] = 0.623), the changes of N-MID, P1NP, and β-CTX and their 1 year levels had similar AUC to diagnose the short-term LS 1-4 BMD change (AUC > 0.7 for all, with the AUC of 1 y P1NP being the largest at 0.803). Binary logistic regression analysis showed that the physical activity and drug intervention were the determinant factors for the LS 1-4 BMD change (odds ratio = 6.856, 95% confidence interval: 2.058-22.839, P = 0.002; odds ratio = 5.114, 95% confidence interval: 1.551-16.864, P = 0.007; respectively). Conclusions: Declining N-MID, P1NP, β-CTX, and Phosphorus are associated with the short-term increase of LS 1-4 BMD within 1 year. Physical activity and drug intervention are factors significantly influencing the change of LS 1-4 BMD in postmenopausal women.

Bone-Metabolism-Related Serum microRNAs to Diagnose Osteoporosis in Middle-Aged and Elderly Women

“…As a direct reflection of the changes in bone homeostasis, the re-review of bone turnover markers (BTMs) in recent years seems to provide new hope for the auxiliary diagnosis of PMOP [ 8 , 9 ]. However, recent studies, including our own, have confirmed that there is a limited correlation between the level of serum BTMs and BMD changes [ 10 , 11 ]. Regretfully, few convenient and accurate biomarkers are currently available for diagnosis in the clinic.…”

Bone-turnover biomarkers as potential prognostic factors in sudden sensorineural hearing loss: A prospective cohort study

“…ALP, N-MID, and β-CTX are markers of bone formation and resorption, which can be easily detected and directly reflect the change in bone metabolism before bone morphological change ( 14 , 21 ). β-CTX is a C-terminal cross-linked peptide of type I collagen, which is produced in the process of collagen decomposition and can be used to indirectly reflect the function and activity of osteoclasts in the skeletal system ( 22 ).…”

“…N-MID is the hydrolytic fragment of osteocalcin secreted by osteoblasts and can be used to reflect the process of bone formation. The declining N-MID and β-CTX were significantly associated with a short-term positive change in Lumber spine 1-4 BMD of postmenopausal women over 1 year ( 14 ). ALP is a group of glycoproteases that can hydrolyze phosphates under alkaline conditions.…”

“…Although there is evidence that osteoporosis contributes to the increased incidence of SSNHL, the relationship between the bone-turnover biomarkers with the prognosis of SSNHL is still unclear. Bone-turnover biomarkers [including alkaline phosphatase (ALP), β-carboxy terminal crosslinked telopeptide of type 1 collagen (β-CTX), N-terminal midfragment of osteocalcin (N-MID)] and related biomarkers [including serum calcium, serum phosphorus (P), 25 hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and calcitonin] can be used as a risk assessment tool for post-menopausal osteoporosis, and some studies even suggested that β-CTX to be better than BMD in predicting senile fractures ( 13 , 14 ). This study prospectively analyzed the correlation between bone-turnover biomarkers and hearing recovery in SSNHL patients.…”

Study on Risk Factors of Primary Non‐traumatic OVCF in Chinese Elderly and a Novel Prediction Model

“…The risk calculators (FRAX®), using clinical risk factors and calculating the 10 year probability of fracture, could effectively predict the hip fracture when combined with BMD, but are complex and limited in predicting the risk of other fractures, especially for OVCF, because the circumstances leading to OVCF are frequently controversial and unknown. 3 , 6 , 12 , 13 In addition to BMD and bone turnover markers (BTM), 14 previous studies also reported that serum albumin, 15 serum cholesterol level, 16 and lumbar muscle mass 17 were associated with osteoporotic fractures. Moreover, a previous study had shown that OVCFs were related to frailty, and conversely, frailty was further worsened after OVCFs due to the deficit accumulation being greater.…”