Serial assessment of serum bone metabolism markers identifies women with the highest rate of bone loss and osteoporosis risk.
BACKGROUND
One of the important challenges in the management of osteoporosis is to identify women who are at high risk of developing osteoporosis and fragility fractures.


OBJECTIVE
Our objective was to evaluate whether assessment of bone metabolism at multiple occasions can identify women with the highest risk for bone loss.


METHODS
The Malmö Osteoporosis Prospective Risk Assessment study is an ongoing longitudinal study. Participants have been evaluated at baseline and after 1, 3, and 5 yr.


METHODS
We conducted a population-based study.


METHODS
Participants included 1044 women, all 75 yr old at baseline.


METHODS
Seven bone turnover markers were assessed at baseline and at 1, 3, and 5 yr (n = 573). The 5-yr change in areal bone mineral density (aBMD) was also determined.


RESULTS
Baseline markers correlated weakly to change in total body aBMD. The associations were more pronounced when the average of the baseline and 1-yr measurements was used (standardized regression coefficients -0.12 to -0.23, P < 0.01). Adding the 3-yr and 5-yr measurement further strengthened the correlation (regression coefficients up to -0.30, P < 0.001). Women with constantly high turnover lost significantly more bone at total body assessment (-2.6%) than women with intermediate (-1.6%) or low turnover (-0.2%, P for trend < 0.001). They also had a greater decrease in hip BMD (-8.3, -6.0, and -5.1%, respectively, P = 0.010). Results were similar also in the subgroup of women with osteopenia.


CONCLUSIONS
Our results suggest that serial assessment of bone turnover improves the identification of women with the highest rate of bone loss and osteoporosis risk.
Ivaska
Kaisa K
KK
Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics, Malmö University Hospital, Malmö, Sweden. kaisa.ivaska@med.lu.se
Lenora
Janaka
J
Gerdhem
Paul
P
Akesson
Kristina
K
Väänänen
H Kalervo
HK
Obrant
Karl J
KJ
D000368:Aged; D015415:Biomarkers; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis*; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis*
D015415:Biomarkers