Vol.21 No.6

Original Article

Biochemical markers of bone turnover as predictors of osteoporosis and osteoporotic fractures in men and women: 10-year follow-up of the Taiji cohort

Authors

Noriko Yoshimura1 , Shigeyuki Muraki2 , Hiroyuki Oka1 , Hiroshi Kawaguchi3 , Kozo Nakamura3 , Toru Akune2

  • Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
  • Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  • Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
Received:

24 December 2010

Accepted:

17 March 2011

Published online:

22 April 2011

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Abstract

We aimed to assess the capacity of biochemical
markers of bone turnover (BTMs) to predict bone loss,
osteoporosis (OP), and osteoporotic fractures. We randomly
selected 400 individuals (age 40-79 years in 1993;
50 of each gender and age stratum) from a list of registered
residents. In the years 1993, 1996, 2000, and 2003, bone
mineral density (BMD) of the spine and hip were measured
by dual-energy X-ray absorptiometry. The BTMs assessed
at baseline were serum intact osteocalcin (OC), total OC,
bone-specific alkaline phosphatase, C-terminal propeptide
of type I procollagen, N-terminal propeptide of type I
procollagen (PINP), C-terminal cross-linking telopeptide
of type I collagen generated by matrix metalloproteinase,
C-terminal cross-linking telopeptide of type I collagen
(beta-CTX), N-terminal cross-linking telopeptide of type I
collagen (NTX), urinary pyridinoline, and deoxypyridinoline
(DPD). For 307 completers, multivariate analysis after
adjusting for confounders revealed that serum PINP levels
in men [hazard ratio (HR) 2.80, P<0.05] and serum PINP
(HR 1.65, P<0.05), beta-CTX (HR 1.80, P<0.001),
NTX (HR 1.96, P<0.01), and urinary DPD levels (HR
1.40, P<0.05) in women were significantly related to the
occurrence of spinal OP. In addition to adjustment for the
baseline status of BMD, i.e., osteopenia or normal range,
PINP, beta-CTX, and NTX in women could significantly
predict the future occurrence of spinal OP. BTMs were not
significant predictors of bone loss, femoral OP, or osteoporotic fractures. In conclusion, various BTMs in women
can predict the occurrence of spinal OP.

Key words

Biochemical markers of bone turnover - Bone resorption - Bone formation - Bone mineral density - Osteoporotic fracture