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Nonenzymatic collagen cross-links induced by glycoxidation (pentosidine) predicts vertebral fractures

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Abstract

Advanced glycation end products (AGE) in collagen have been reported to decrease the mechanical property of bone. However, there are no available data on the relation between fracture risk and levels of glycoxidative (nonenzymatic) cross-links of collagen in clinical samples. A total of 432 Japanese elderly women who were not receiving any drug treatment for osteoporosis were selected and followed for 5.2 ± 3.3 (mean ± SD) years for this observational study. Vertebral fractures and bone mineral density were assessed at baseline and then at 1- to 2-year intervals or at indication of any symptom. Two types of collagen metabolites were measured at baseline: urinary N-terminal telopeptide of type I collagen (NTX), a marker of pyridinium cross-link, and urinary pentosidine, a nonenzymatic collagen cross-link produced by AGEs. A total of 97 incident vertebral fractures on 72 subjects were observed. Simple regression analysis using Cox's hazards model showed that log-transformed urinary NTX and pentosidine are significant risk factors for time-dependent incidence of vertebral fractures, in addition to the traditional risk factors (age, lumbar bone mineral density, and number of prevalent vertebral fractures). However, urinary excretion of pentosidine (hazard ratio, 1.33; 95% CI, 1.01–1.76, P = 0.04) was a significant predictor of incident vertebral fracture after adjustment for other traditional risk factors. The present data suggest that AGE-related collagen cross-link is a novel risk for vertebral fracture.

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Authors and Affiliations

  1. Department of Internal Medicine, Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano, 399-8101, Japan

    Masataka Shiraki

  2. Department of Obstetric and Gynecology, Tokyo Women's Medical University, Tokyo, Japan

    Tatsuhiko Kuroda

  3. Department of Epidemiology and Biostatistics, Tokyo University, Tokyo, Japan

    Shiro Tanaka

  4. Department of Orthopedic Surgery, Jikei University School of Medicine, Tokyo, Japan

    Mitsuru Saito

  5. Department of Nuclear Medicine, Kawasaki Medical School, Okayama, Japan

    Masao Fukunaga

  6. Department of Orthopedic Surgery, University of Occupational and Environmental Health, Fukuoka, Japan

    Toshitaka Nakamura

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  1. Masataka Shiraki
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  2. Tatsuhiko Kuroda
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Correspondence to Masataka Shiraki.

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Shiraki, M., Kuroda, T., Tanaka, S. et al. Nonenzymatic collagen cross-links induced by glycoxidation (pentosidine) predicts vertebral fractures. J Bone Miner Metab 26, 93–100 (2008). https://doi.org/10.1007/s00774-007-0784-6

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