Abstract

BackgroundThe rate of bone turnover is closely related to osteoporosis risk. We investigated the correlation between bone turnover markers and BMD at various skeletal sites in healthy native Chinese women, and to study the effect of changes in the levels of bone turnover markers on the risk of osteoporosis.MethodsA cross-section study of 891 healthy Chinese women aged 20–80 years was conducted. The levels of serum osteocalcin (OC), bone-specific alkaline phosphatase (BAP), serum cross-linked N-terminal telopeptides of type I collagen (sNTX), cross-linked C-terminal telopeptides of type I collagen (sCTX), urinary NTX (uNTX), urinary CTX (uCTX) and total urinary deoxypyridinoline (uDPD) were determined. BMD at the posteroanterior spine and the hip was measured using DXA.ResultsPearson’s correlation coefficient found significant negative correlation between bone turnover marker and BMD T-score at different skeletal sites (r = −0.08 to −0.52, all P = 0.038–0.000). After adjustments for age and body mass index, the partial correlation coefficients between the OC, BAP, sNTX, sCTX and uCTX, and the T-scores at various skeletal sites were still significant. After adjustment of height and weight, the correlation coefficients between most BTMs and PA lumbar spine BMD were also significant. Multiple linear regression analysis showed that bone turnover markers were negative determinants of T-scores. BAP and OC accounted for 33.1% and 7.8% of the variations in the T-scores of the PA spine, respectively. Serum OC, BAP, uDPD, and sNTX accounted for 0.4–21.9% of the variations in the femoral neck and total hip T-scores. The bone turnover marker levels were grouped as per quartile intervals, and the T-scores, osteoporosis prevalence and risk were found to markedly and increase with increase in bone turnover marker levels.ConclusionsThis study clarified the relationship between bone turnover markers and osteoporosis risk in native Chinese women. Bone turnover marker levels were found to be important determinants of BMD T-scores. Furthermore, osteoporotic risk significantly increased with increase in the levels of bone turnover markers.

Highlights

  • The rate of bone turnover is closely related to osteoporosis risk

  • All bone turnover marker levels were lowest in women aged 30–39 years, the levels of bone-specific alkaline phosphatase (BAP), OC, urinary NTX (uNTX), urinary CTX (uCTX) and urinary deoxypyridinoline (uDPD) increased significantly in women aged 40–49 years, and all levels increased further still in women aged over 50 years

  • Using the T-scores as dependent variables and bone turnover markers as independent variables, we found that changes in levels of BAP and OC significantly influenced the T-scores of the Posteroanterior spine (PA) spine; these levels jointly accounted for 40.9% of the variations in the T-scores of the PA spine

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Summary

Introduction

The rate of bone turnover is closely related to osteoporosis risk. We investigated the correlation between bone turnover markers and BMD at various skeletal sites in healthy native Chinese women, and to study the effect of changes in the levels of bone turnover markers on the risk of osteoporosis. In total 891 healthy women living in the central and southern areas of China underwent tests for bone formation markers, including serum bone-specific alkaline phosphatase (BAP) and serum osteocalcin (OC), and bone resorption markers, including serum cross-linked N-terminal telopeptides of type I collagen (sNTX), serum cross-linked C-terminal telopeptides of type I collagen (sCTX), urinary NTX (uNTX), urinary CTX (uCTX) and total urinary deoxypyridinoline (uDPD). They underwent dual energy X ray absorptiometry to determine BMD of the posteroanterior aspect of the lumbar vertebrae and proximal femur

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