Biochemical markers of bone turnover and risk of incident hip fracture in older women: the Cardiovascular Health Study

被引:11
作者
Massera, D. [1 ]
Xu, S. [2 ]
Walker, M. D. [3 ]
Valderrabano, R. J. [4 ]
Mukamal, K. J. [5 ]
Ix, J. H. [6 ]
Siscovick, D. S. [7 ]
Tracy, R. P. [8 ]
Robbins, J. A. [9 ]
Biggs, M. L. [10 ]
Xue, X. [2 ]
Kizer, J. R. [11 ,12 ]
机构
[1] NYU, Sch Med, New York, NY USA
[2] Albert Einstein Coll Med, Bronx, NY 10467 USA
[3] Columbia Univ, Coll Phys & Surg, New York, NY USA
[4] Univ Miami, Miami, FL USA
[5] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[6] Univ Calif San Diego, San Diego, CA 92103 USA
[7] New York Acad Med, New York, NY USA
[8] Univ Vermont, Burlington, VT USA
[9] Univ Calif Davis, Sacramento, CA 95817 USA
[10] Univ Washington, Seattle, WA 98195 USA
[11] San Francisco Vet Affairs Hlth Care Syst, Cardiol Sect, San Francisco, CA 94121 USA
[12] Univ Calif San Francisco, 4150 Clement St, San Francisco, CA 94121 USA
关键词
Bone turnover markers; Hip fracture risk; Osteoporosis; Postmenopausal women; ELDERLY-WOMEN; UNDERCARBOXYLATED OSTEOCALCIN; POSTMENOPAUSAL WOMEN; MINERAL DENSITY; PREDICTION; RESORPTION; ASSOCIATION; METABOLISM; ADULTS; SIZE;
D O I
10.1007/s00198-019-05043-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:1755 / 1765
页数:11
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