Biochemical markers of bone turnover in percutaneous vertebroplasty for osteoporotic compression fracture.
OBJECTIVE
To evaluate relationships between biochemical markers of bone turnover, bone mineral density, and new compression fractures following vertebroplasty.


METHODS
Initially, we enrolled 30 consecutive patients with vertebral compression fractures caused by osteoporosis. Twenty-three of the 30 patients visited our hospital for follow-up examinations for more than 4 weeks after vertebroplasty. The patients were divided into two groups: patients with new fractures (group F) and patients with no new fractures (group N). We analyzed differences in the following parameters between these two groups: serum bone alkaline phosphatase, urinary crosslinked N-telopeptide of type I collagen, urinary deoxypyridinoline, and bone mineral density. Next, the patients were divided into another two groups: patients with higher risk (group H: urinary crosslinked N-telopeptide of type I collagen >54.3 nmol BCE/mmol Cr or urinary deoxypyridinoline >7.6 nmol/mmol Cr, and serum bone alkaline phosphatase <29.0 U/l) and patients with lower risk (group L). We analyzed the difference in the rate of new fractures between these two groups.


RESULTS
We identified 9 new fractures in 7 patients. There were no significant differences between groups F and N. We identified 5 new fractures in 3 of the 4 patients in group H, and 4 new fractures in 4 of the 19 patients in group L. There was a significant difference in the rate of new fractures between groups H and L.


CONCLUSIONS
A combination of high levels of bone resorption markers and normal levels of bone formation markers may be associated with increased risk of new recurrent fractures after percutaneous vertebroplasty.
Komemushi
Atsushi
A
Department of Radiology, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan. kome64@yo.rim.or.jp
Tanigawa
Noboru
N
Kariya
Shuji
S
Kojima
Hiroyuki
H
Shomura
Yuzo
Y
Tokuda
Takanori
T
Nomura
Motoo
M
Terada
Jiro
J
Kamata
Minoru
M
Sawada
Satoshi
S
D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000097:blood* / Q000652:urine*; D015519:Bone Density; D001862:Bone Resorption; D016009:Chi-Square Distribution; D024042:Collagen Type I / Q000652:urine; D005260:Female; D050815:Fractures, Compression / Q000097:blood* / Q000209:etiology / Q000601:surgery / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D010455:Peptides / Q000652:urine; D015641:Radiography, Interventional; D012307:Risk Factors
D000596:Amino Acids; D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; C036020:deoxypyridinoline; D000469:Alkaline Phosphatase