title: Urinary pentosidine and plasma homocysteine levels at baseline predict future fractures in osteoporosis patients under bisphosphonate treatment.
abstract: To clarify what kind of risk factors predict incident fractures in patients treated with bisphosphonates, the authors investigated the relationship between baseline characteristics and incident vertebral fracture in Japanese osteoporosis patients undergoing bisphosphonate treatment. This was a multi-center follow-up study conducted at three centers, in which a total of 251 Japanese patients with osteoporosis (mean age 70.5 years) from the three centers were followed for 3.2 ± 2.0 years. Baseline data, including pre-existing fractures, bone mineral density in the lumbar spine (LBMD), bone metabolic markers, urinary pentosidine, and plasma homocysteine, were evaluated. Changes in LBMD, bone turnover markers, and incident fractures after the treatment were followed. Sixty-one patients developed incident vertebral fractures; this group of patients was older and had lower LBMD, a higher prevalent vertebral fracture number, and higher homocysteine and pentosidine levels than patients who did not develop incident vertebral fractures. Changes in LBMD, urinary N-terminal telopeptides of type I collagen (NTX), and bone-derived alkaline phosphatase showed no significant association with the occurrence of vertebral fractures. Cox's proportional hazard model demonstrated that age, prevalent fracture, pentosidine, and homocysteine were independent predictors of the incident vertebral fracture rate under bisphosphonate treatment. Higher baseline levels of pentosidine and homocysteine in osteoporosis patients are potential risk factors for incident vertebral fractures when these patients are treated with bisphosphonates. Further clarification is needed to explain why such patients have higher fracture susceptibility.
authors.affiliation: Research Institute and Practice for Involutional Diseases, Nagano, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Shiraki
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kuroda
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Shiraki
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Higuchi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Saito
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000652:urine; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000097:blood / Q000517:prevention & control / Q000652:urine; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives* / Q000652:urine; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood* / Q000188:drug therapy / Q000652:urine*; D016016:Proportional Hazards Models
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D006710:Homocysteine; D001120:Arginine; C062187:pentosidine; D008239:Lysine
references.citation: Calcif Tissue Int. 2006 Sep;79(3):160-8
references.pmid: 16969591
references.citation: Bone. 2000 Nov;27(5):687-94
references.pmid: 11062357
references.citation: J Bone Miner Res. 2003 Jun;18(6):1051-6
references.pmid: 12817758
references.citation: J Clin Endocrinol Metab. 1994 Dec;79(6):1693-700
references.pmid: 7989477
references.citation: Osteoporos Int. 2010 Apr;21(4):655-66
references.pmid: 19484165
references.citation: Bone. 2004 Apr;34(4):599-604
references.pmid: 15050889
references.citation: Ann N Y Acad Sci. 2005 Jun;1043:710-7
references.pmid: 16037297
references.citation: J Clin Endocrinol Metab. 2008 Mar;93(3):1013-9
references.pmid: 18160470
references.citation: Lancet. 1996 Dec 7;348(9041):1535-41
references.pmid: 8950879
references.citation: J Bone Miner Res. 2004 Feb;19(2):323-9
references.pmid: 14969403
references.citation: N Engl J Med. 2004 May 13;350(20):2042-9
references.pmid: 15141042
references.citation: Osteoporos Int. 2010 Feb;21(2):243-50
references.pmid: 19421701
references.citation: Am J Med. 2002 Mar;112(4):281-9
references.pmid: 11893367
references.citation: Osteoporos Int. 2010 Feb;21(2):195-214
references.pmid: 19760059
references.citation: J Bone Miner Res. 1997 Sep;12(9):1438-45
references.pmid: 9286760
references.citation: Biol Pharm Bull. 1998 Oct;21(10):1005-8
references.pmid: 9821800
references.citation: N Engl J Med. 2001 May 10;344(19):1434-41
references.pmid: 11346808
references.citation: J Bone Miner Metab. 2001;19(6):331-7
references.pmid: 11685647
references.citation: JAMA. 1999 Aug 18;282(7):637-45
references.pmid: 10517716
references.citation: Eur J Clin Chem Clin Biochem. 1991 Sep;29(9):549-54
references.pmid: 1760484
references.citation: Osteoporos Int. 2009 Jun;20(6):887-94
references.pmid: 18850239
references.citation: J Bone Miner Metab. 2008;26(6):595-602
references.pmid: 18979159
references.citation: Arthritis Rheum. 2001 Nov;44(11):2611-9
references.pmid: 11710717
references.citation: Bone. 2009 Dec;45(6):1053-8
references.pmid: 19679211
references.citation: J Bone Miner Res. 1996 Jul;11(7):984-96
references.pmid: 8797120
references.citation: JAMA. 1999 Oct 13;282(14):1344-52
references.pmid: 10527181
references.citation: N Engl J Med. 2004 May 13;350(20):2033-41
references.pmid: 15141041
references.citation: Osteoporos Int. 2006;17(7):986-95
references.pmid: 16552468
references.citation: BMJ. 2009 Jun 23;338:b2266
references.pmid: 19549996
references.citation: Bone. 2002 Jul;31(1):1-7
references.pmid: 12110404
references.citation: Curr Osteoporos Rep. 2007 Jun;5(2):62-6
references.pmid: 17521507
references.citation: Osteoporos Int. 2008 Sep;19(9):1343-54
references.pmid: 18373056
references.citation: J Bone Miner Metab. 2008;26(1):93-100
references.pmid: 18095070
references.citation: JAMA. 2001 Feb 14;285(6):785-95
references.pmid: 11176917
references.citation: JAMA. 1998 Dec 23-30;280(24):2077-82
references.pmid: 9875874
references.citation: Bone. 2006 Mar;38(3):300-9
references.pmid: 16271523
references.citation: N Engl J Med. 2007 Nov 1;357(18):1799-809
references.pmid: 17878149
references.citation: J Clin Endocrinol Metab. 2009 Jul;94(7):2380-6
references.pmid: 19383780
references.citation: J Bone Miner Metab. 2006;24(3):219-25
references.pmid: 16622735