Associations of plasma osteocalcin and fetuin‐A with bone mineral density in post‐menopausal women (867.16)

Abstract

In postmenopausal women, decreases in estrogen disrupt the normal balance of bone turnover, increasing bone resorption relative to bone formation. This study investigated the effects of menopausal hormone treatment (MHT) on volumetric bone mineral density (vBMD) and markers of bone turnover in plasma of healthy, recently‐menopausal women. Women (age 52.3±2.3 yrs; n=115) enrolled in the Kronos Early Estrogen Prevention Study (KEEPS) were randomized to either: oral conjugated equine estrogen (oCEE), transdermal 17β estradiol (tE2) each with intermittent oral micronized progesterone or placebo (Pl), for 48 months. vBMD was assessed by quantitative computed tomography of the wrist, and plasma levels of osteocalcin (OCN; a bone turnover marker), and of Fetuin‐A, a hepatocyte‐derived modulator of osteogenesis, were quantified by ELISA. At 48 months, cortical vBMD at the distal radius had decreased by 2.9% in the Pl group, correspondent with an increase above initial plasma OCN (15.0 ng/ml) of 38.5%. MHT attenuated the vBMD decrease (0.9% in both treatment groups combined; P=0.015), and the OCN increase (8.8 and 4.3% in oCEE and tE2, respectively). Plasma Fetuin‐A levels did not differ significantly among groups at 48 mo. Unexpectedly, Fetuin‐A was negatively associated (r=‐0.50 to ‐0.62; P <0.05) with changes in trabecular bone microarchitectural parameters at the distal radius in the Pl group, whereas both oCEE and tE2 attenuated this effect (all P‐values >0.05). As expected, MHT attenuated bone turnover in postmenopausal women. However, the relationship between processes regulated by OCN and Fetuin‐A require further evaluation.Grant Funding Source: Supported by Aurora Foundation, HL90639 and AG44170