Correlation between Bone Turnover Markers and Bone Mineral Density in Patients Undergoing Long-Term Anti-Osteoporosis Treatment: A Systematic Review and Meta-Analysis

Lingyun Hong,Meiqi Wang,Lan Ma,Yu Cen,Dan Liu,Feng Wu

doi:10.3390/app10030832

Lingyun Hong, Meiqi Wang + Show 4 more

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https://doi.org/10.3390/app10030832

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Abstract

This systematic review and meta-analysis aimed to evaluate the correlations between the bone turnover markers (BTMs) and the bone mineral density (BMD) in patients treated for primary osteoporosis and to identify promising BTMs for the prediction of future BMD changes. The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for relevant studies that investigated the relationship between the BTMs and the BMD changes in patients treated for osteoporosis. All significant correlation coefficients of the baseline BTMs or changes in BTMs from baseline with the BMD changes from baseline under different interventions from eligible studies were used for systematic review and the subgroup analyses. The correlations were analyzed in terms of bone sites, intervention, time duration of BTMs measurements, and time duration of BMD measurements. Twenty-two records reporting correlation coefficients and the corresponding p-values were included, 13 of which were enrolled in the further subgroup analyses. The combined results from the systematic review and meta-analyses indicated that the changes in osteocalcin (OC), procollagen type I N propeptide (PINP), and urine N-terminal crosslinking telopeptide of type I collagen (U-NTX), or the PINP at baseline tended to be useful in evaluating the long-term BMD changes after drug intervention.

Highlights

Osteoporosis is a systemic skeletal disorder that is characterized by low bone mass, decreased bone strength, and the microarchitectural deterioration of bone tissue
22 records were eligible for this systematic review, among which 13 records were included in the further meta-analysis
According to the results of the subgroup analyses, we found that the baseline procollagen type I N propeptide (PINP) values were moderately and positively correlated with the bone mineral density (BMD) changes (CORPINP = 0.42, 95% CI: 0.34–0.50, heterogeneity: I2 = 0%, p = 0.4), while the correlations between other bone turnover markers (BTMs) and BMD changes were lower than 0.4, indicating that the other baseline BTMs

Summary

Introduction

Osteoporosis is a systemic skeletal disorder that is characterized by low bone mass, decreased bone strength, and the microarchitectural deterioration of bone tissue. Sci. 2020, 10, 832 asymptomatically, and it is generally found at a first occurrence of fragility fracture. Due to the serious consequences of osteoporosis, fractures often cause a heavy economic burden, severely impact patients’. Quality of life, and increase disability and mortality, especially when a fracture occurs at the hip [1]. Clinical therapies for the treatment of primary osteoporosis (i.e., menopause- and aging-related osteoporosis) are mainly classified as antiresorptive and anabolic. The anti-osteoporosis drugs approved by the United States Food and Drug Administration (FDA) include bisphosphonates (BPs)

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