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Association of bone turnover markers with volumetric bone loss, periosteal apposition, and fracture risk in older men and women: the AGES-Reykjavik longitudinal study

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Abstract

Summary

Association between serum bone formation and resorption markers and cortical and trabecular bone loss and the concurrent periosteal apposition in a population-based cohort of 1069 older adults was assessed. BTM levels moderately reflect the cellular events at the endosteal and periosteal surfaces but are not associated with fracture risk.

Introduction

We assessed whether circulating bone formation and resorption markers (BTM) were individual predictors for trabecular and cortical bone loss, periosteal expansion, and fracture risk in older adults aged 66 to 93 years from the AGES-Reykjavik study.

Methods

The sample for the quantitative computed tomography (QCT)-derived cortical and trabecular BMD and periosteal expansion analysis consisted of 1069 participants (474 men and 595 women) who had complete baseline (2002 to 2006) and follow-up (2007 to 2011) hip QCT scans and serum baseline BTM. During the median follow-up of 11.7 years (range 5.4–12.5), 54 (11.4 %) men and 182 (30.6 %) women sustained at least one fracture of any type.

Results

Increase in BTM levels was associated with faster cortical and trabecular bone loss at the femoral neck and proximal femur in men and women. Higher BTM levels were positively related with periosteal expansion rate at the femoral neck in men. Markers were not associated with fracture risk.

Conclusion

This data corroborates the notion from few previous studies that both envelopes are metabolically active and that BTM levels may moderately reflect the cellular events at the endosteal and periosteal surfaces. However, our results do not support the routine use of BTM to assess fracture risk in older men and women. In light of these findings, further studies are justified to examine whether systemic markers of bone turnover might prove useful in monitoring skeletal remodeling events and the effects of current osteoporosis drugs at the periosteum.

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Acknowledgments

This study was funded by the National Institutes of Health contract N01-AG-012100, the National Institute on Aging Intramural Research Program, Hjartavernd (the Icelandic Heart Association), and the Althingi (the Icelandic Parliament). EAM and TBH were supported in part by and the Intramural Research Program of the National Institutes of Health, National Institute on Aging.

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Authors and Affiliations

  1. Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA

    E. A. Marques, L. Launer & T. B. Harris

  2. Icelandic Heart Association Research Institute, Kópavogur, Iceland

    V. Gudnason, G. Sigurdsson, S. Sigurdsson, T. Aspelund, K. Siggeirsdottir & G. Eiriksdottir

  3. University of Iceland, Reykjavik, Iceland

    V. Gudnason & G. Sigurdsson

  4. Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA

    T. Lang

  5. Landspitalinn University Hospital, Reykjavik, Iceland

    G. Sigurdsson

  6. Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland

    T. Aspelund

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  1. E. A. Marques
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  2. V. Gudnason
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Correspondence to E. A. Marques.

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Elisa A Marques, Vilmundur Gudnason, Thomas Lang, Gunnar Sigurdsson, Sigurdur Sigurdsson, Thor Aspelund, Kristin Siggeirsdottir, Lenore Launer, Gudny Eiriksdottir, and Tamara B Harris declare that they have no disclosures.

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Marques, E.A., Gudnason, V., Lang, T. et al. Association of bone turnover markers with volumetric bone loss, periosteal apposition, and fracture risk in older men and women: the AGES-Reykjavik longitudinal study. Osteoporos Int 27, 3485–3494 (2016). https://doi.org/10.1007/s00198-016-3675-7

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