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Association of bone turnover markers with mortality in men referred to coronary angiography

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Abstract

Summary

We aimed to examine the association of fatal events with osteocalcin (OC) and beta-crosslaps (β-CTX) levels in men. We observed a U-shaped association of OC and β-CTX levels with fatal events in a large cohort of men at high cardiovascular risk.

Introduction

Accumulating evidence suggests an association of low OC levels with metabolic disturbances. Whether OC levels are related to fatal events is, however, less clear. Further, high β-CTX levels are linked to increased mortality. We aimed to examine the association of fatal events with both OC and β-CTX in men.

Methods

We measured OC and β-CTX in 2,271 men referred to coronary angiography (1997–2000).

Results

We observed a U-shaped association of OC and β-CTX with fatal events. Crude hazard ratios (HRs) for all-cause and non-cardiovascular mortality in the highest OC quintile were 1.38 (1.04–1.83) and 1.47 (0.89–2.40), respectively, and 2.11 (1.61–2.75) and 2.06 (1.29–3.29) for men in the lowest compared to the third OC quintile. In multivariate-adjusted models, HRs for all-cause, and non-cardiovascular mortality in the lowest OC quintile were 1.63 (1.23–2.16) and 1.79 (1.10–2.92), respectively, compared to the third OC quintile, whereas the association of high OC with mortality lost its significance. Crude and multivariate-adjusted HRs for cardiovascular mortality in the lowest OC quintile compared to the third OC quintile were 2.08 (1.49–2.90) and 1.74 (1.24–2.46), respectively. Moreover, high as well as low β-CTX levels were independently associated with all-cause (quintile 1 vs. quintile 3: HR 1.42 (1.05–1.92); quintile 5 vs. quintile 3: HR 1.79 (1.31–2.45)) and cardiovascular mortality (quintile 1 vs. quintile 3: HR 1.55 (1.05–2.28); quintile 5 vs. quintile 3: HR 1.85 (1.23–2.77)).

Conclusions

We observed a U-shaped association of OC and β-CTX with fatal events in a large cohort of men at high cardiovascular risk.

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Acknowledgments

LURIC has received funding through the 6th Framework Program (integrated project Bloodomics, grant LSHM-CT-2004-503485) and 7th of Framework Program (integrated project Atheroremo, Grant Agreement number 201668) of the European Union. B.O.B. received grants from the DFG GrK 1041 and DFG-SFB 518. Roche Diagnostics Austria provided the reagents for the determination of OC and BTCX free of charge, but did not assume any other role in the conduct of the study.

Conflicts of interest

The authors declare no competing interest

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria

    E. Lerchbaum, V. Schwetz, S. Pilz & B. Obermayer-Pietsch

  2. Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

    S. Pilz

  3. Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany

    T. B. Grammer & W. März

  4. Synlab Center MVZ Neuwied GmbH, Neuwied, Germany

    M. Look

  5. Department of Internal Medicine, Division of Endocrinology and Diabetes, Ulm University, Ulm, Germany

    B. O. Boehm

  6. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria

    W. März

  7. SynlabAcademy, Mannheim, Germany

    W. März

Authors
  1. E. Lerchbaum
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  2. V. Schwetz
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  3. S. Pilz
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  7. B. Obermayer-Pietsch
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  8. W. März
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Corresponding author

Correspondence to E. Lerchbaum.

Additional information

Elisabeth Lerchbaum and Verena Schwetz contributed equally to the manuscript.

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Lerchbaum, E., Schwetz, V., Pilz, S. et al. Association of bone turnover markers with mortality in men referred to coronary angiography. Osteoporos Int 24, 1321–1332 (2013). https://doi.org/10.1007/s00198-012-2076-9

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  • DOI: https://doi.org/10.1007/s00198-012-2076-9

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