title: Association of bone turnover markers with mortality in men referred to coronary angiography.
abstract: We aimed to examine the association of fatal events with osteocalcin (OC) and beta-crosslaps (β-CTX) levels in men. We observed a U-shaped association of OC and β-CTX levels with fatal events in a large cohort of men at high cardiovascular risk.
  
  
  BACKGROUND
  Accumulating evidence suggests an association of low OC levels with metabolic disturbances. Whether OC levels are related to fatal events is, however, less clear. Further, high β-CTX levels are linked to increased mortality. We aimed to examine the association of fatal events with both OC and β-CTX in men.
  
  
  METHODS
  We measured OC and β-CTX in 2,271 men referred to coronary angiography (1997-2000).
  
  
  RESULTS
  We observed a U-shaped association of OC and β-CTX with fatal events. Crude hazard ratios (HRs) for all-cause and non-cardiovascular mortality in the highest OC quintile were 1.38 (1.04-1.83) and 1.47 (0.89-2.40), respectively, and 2.11 (1.61-2.75) and 2.06 (1.29-3.29) for men in the lowest compared to the third OC quintile. In multivariate-adjusted models, HRs for all-cause, and non-cardiovascular mortality in the lowest OC quintile were 1.63 (1.23-2.16) and 1.79 (1.10-2.92), respectively, compared to the third OC quintile, whereas the association of high OC with mortality lost its significance. Crude and multivariate-adjusted HRs for cardiovascular mortality in the lowest OC quintile compared to the third OC quintile were 2.08 (1.49-2.90) and 1.74 (1.24-2.46), respectively. Moreover, high as well as low β-CTX levels were independently associated with all-cause (quintile 1 vs. quintile 3: HR 1.42 (1.05-1.92); quintile 5 vs. quintile 3: HR 1.79 (1.31-2.45)) and cardiovascular mortality (quintile 1 vs. quintile 3: HR 1.55 (1.05-2.28); quintile 5 vs. quintile 3: HR 1.85 (1.23-2.77)).
  
  
  CONCLUSIONS
  We observed a U-shaped association of OC and β-CTX with fatal events in a large cohort of men at high cardiovascular risk.
authors: Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria. elisabeth.lerchbaum@medunigraz.at
authors: E
authors: E
authors: Lerchbaum
authors: V
authors: V
authors: Schwetz
authors: S
authors: S
authors: Pilz
authors: T B
authors: TB
authors: Grammer
authors: M
authors: M
authors: Look
authors: B O
authors: BO
authors: Boehm
authors: B
authors: B
authors: Obermayer-Pietsch
authors: W
authors: W
authors: März
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016723:Bone Remodeling / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D003094:Collagen / Q000097:blood*; D017023:Coronary Angiography; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015675:Osteocalcin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D015675:Osteocalcin; D003094:Collagen