TY - JOUR
T1 - Biochemical markers of bone turnover and risk of incident hip fracture in older women
T2 - the Cardiovascular Health Study
AU - Massera, D.
AU - Xu, S.
AU - Walker, M. D.
AU - Valderrábano, R. J.
AU - Mukamal, K. J.
AU - Ix, J. H.
AU - Siscovick, D. S.
AU - Tracy, R. P.
AU - Robbins, J. A.
AU - Biggs, M. L.
AU - Xue, X.
AU - Kizer, J. R.
N1 - Publisher Copyright:
© 2019, International Osteoporosis Foundation and National Osteoporosis Foundation.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Summary: The relationships of osteocalcin (OC) and C-telopeptide of type I collagen (CTX) with long-term incidence of hip fracture were examined in 1680 post-menopausal women from a population-based study. CTX, but not OC, levels were associated with incident hip fracture in these participants, a relationship characterized by an inverted U-shape. Introduction: We sought to investigate the relationships of OC, a marker of bone formation, and CTX, a marker of bone resorption, with long-term incidence of hip fracture in older women. Methods: We included 1680 women from the population-based Cardiovascular Health Study (mean [SD] age 74.5 [5.0] years). The longitudinal association of both markers with incidence of hip fracture was examined using multivariable Cox models. Results: During a median follow-up of 12.3 years, 288 incident hip fractures occurred. Linear spline analysis did not demonstrate an association between OC levels and incident hip fracture. By contrast, increasing levels of CTX up to the middle-upper range were associated with a significantly greater risk of hip fracture (HR = 1.52 per SD increment, 95% CI = 1.10–2.09), while further increases were associated with a marginally non-significant lower risk (HR = 0.80 per SD increment, 95% CI = 0.63–1.01), after full adjustment for potential confounders. In analyses of quartiles, CTX exhibited a similar inverted U-shaped relationship with incident fracture after adjustment, with a significant association observed only for the comparison of quartile 3 to quartile 1 (HR = 1.63, 95% CI = 1.10–2.43). In a subset with available measures, both OC and CTX were inversely associated with bone mineral density of the hip. Conclusion: CTX, but not OC, levels were associated with incident hip fracture in post-menopausal women, a relationship characterized by an inverted U-shape. These findings highlight the complex relationship of bone turnover markers with hip fracture risk.
AB - Summary: The relationships of osteocalcin (OC) and C-telopeptide of type I collagen (CTX) with long-term incidence of hip fracture were examined in 1680 post-menopausal women from a population-based study. CTX, but not OC, levels were associated with incident hip fracture in these participants, a relationship characterized by an inverted U-shape. Introduction: We sought to investigate the relationships of OC, a marker of bone formation, and CTX, a marker of bone resorption, with long-term incidence of hip fracture in older women. Methods: We included 1680 women from the population-based Cardiovascular Health Study (mean [SD] age 74.5 [5.0] years). The longitudinal association of both markers with incidence of hip fracture was examined using multivariable Cox models. Results: During a median follow-up of 12.3 years, 288 incident hip fractures occurred. Linear spline analysis did not demonstrate an association between OC levels and incident hip fracture. By contrast, increasing levels of CTX up to the middle-upper range were associated with a significantly greater risk of hip fracture (HR = 1.52 per SD increment, 95% CI = 1.10–2.09), while further increases were associated with a marginally non-significant lower risk (HR = 0.80 per SD increment, 95% CI = 0.63–1.01), after full adjustment for potential confounders. In analyses of quartiles, CTX exhibited a similar inverted U-shaped relationship with incident fracture after adjustment, with a significant association observed only for the comparison of quartile 3 to quartile 1 (HR = 1.63, 95% CI = 1.10–2.43). In a subset with available measures, both OC and CTX were inversely associated with bone mineral density of the hip. Conclusion: CTX, but not OC, levels were associated with incident hip fracture in post-menopausal women, a relationship characterized by an inverted U-shape. These findings highlight the complex relationship of bone turnover markers with hip fracture risk.
KW - Bone turnover markers
KW - Hip fracture risk
KW - Osteoporosis
KW - Postmenopausal women
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U2 - 10.1007/s00198-019-05043-1
DO - 10.1007/s00198-019-05043-1
M3 - Article
C2 - 31227885
AN - SCOPUS:85068175988
SN - 0937-941X
VL - 30
SP - 1755
EP - 1765
JO - Osteoporosis International
JF - Osteoporosis International
IS - 9
ER -
