Feasibility of simultaneous measurement of bone formation and bone resorption markers to assess bone turnover rate in postmenopausal women: an EPOLOS study.
BACKGROUND
One of the most important risk factors for osteoporotic fractures in postmenopausal women is elevated bone turnover (EBT), occurring in 25-30% of this population. This study's aim was to find a correlation between bone resorption and bone formation markers to assess bone turnover rate and qualify an individual postmenopausal woman as a possible EBT subject.


METHODS
Three hundred twenty postmenopausal women (> or = one year after the last menstruation, < or = 70 years old) were enrolled at seven clinical sites in this cross-sectional observational study conducted within the EPOLOS. The group was a random sample of the population. The study was performed in a referral center involved in the diagnosis and treatment of osteoporosis. The exclusion criteria included pregnancy, cancer, fracture in the last year, and overweight (> 100 kg). Bone mineral density (BMD) measurements of the lumbar spine, total hip, trochanter, and femoral neck regions were performed. Bone resorption and formation rates were evaluated by serum levels of C-terminal telopeptide of type I collagen (CTX) and osteocalcin (OC), respectively.


RESULTS
Using logistic regression to correlate the concentrations of CTX and OC it was possible not only to distinguish the EBT subgroup, but also to construct a simple nomogram for easy classification of individual patients as possible EBT subjects. EBT patients showed generally decreased BMD values and increased bone formation and resorption rates.


CONCLUSIONS
Evaluation of both CTX and OC levels enables a more proper indication for EBT. The proposed nomogram may assist in evaluating outcome from the two markers of bone turnover.
Łukaszkiewicz
Jacek
J
Department of Biochemical and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
Karczmarewicz
Elzbieta
E
Płudowski
Paweł
P
Jaworski
Maciej
M
Czerwiński
Edward
E
Lewiński
Andrzej
A
Marcinowska-Suchowierska
Ewa
E
Milewicz
Andrzej
A
Spaczyński
Marek
M
Lorenc
Roman S
RS
D015502:Absorptiometry, Photon; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001846:Bone Development; D001862:Bone Resorption; D024042:Collagen Type I / Q000097:blood / Q000737:chemistry; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D017698:Postmenopause
D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D015675:Osteocalcin