title: Bone turnover markers predict hip bone loss in elderly European men: results of the European Male Ageing Study (EMAS).
abstract: CONCLUSIONS
  The aim of this study was to determine whether bone turnover markers (BTMs) predict changes in areal bone mineral density (aBMD) in middle-aged and elderly European men. Older men with high bone turnover are at a higher risk of accelerated hip bone loss, but the clinical utility of BTMs in individuals is limited.
  
  
  BACKGROUND
  Prospective studies on the value of BTMs to predict changes in aBMD in men are few and conflicting. The aim of this study was to determine whether BTMs predict changes in aBMD in middle-aged and elderly European men.
  
  
  METHODS
  In 487 men aged 40-79 years from the European Male Ageing Study (EMAS), BTMs were assessed at baseline and dual-energy X-ray absorptiometry (DXA) at the lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed at baseline and after a mean follow-up of 4.3 years.
  
  
  RESULTS
  The mean aBMD decreased by 0.32%/year at FN and 0.22%/year at TH and increased by 0.32%/year at LS. Higher baseline levels of β C-terminal cross-linked telopeptide (β-CTX) and N-terminal propeptide of type I procollagen (PINP) were significantly associated with higher loss of hip aBMD in the whole cohort and men aged 60-79 years. These associations remained significant after adjustment for age, centre and body mass index (BMI). Men aged 60-79 years with β-CTX in the upper quintile were more likely of being in the upper quintile of annual percentage (%) aBMD loss at FN (OR=4.27; 95% CI=2.09-8.73) and TH (OR=3.73; 95% CI=1.84-7.57). The positive predictive value (PPV) was 46% at both hip sites.
  
  
  CONCLUSIONS
  Older men with high bone turnover have a higher risk of accelerated hip bone loss, but the PPV is low. BTMs are therefore unlikely to be of clinical utility in predicting accelerated hip bone loss in individual subjects.
authors.affiliation: Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium, evelien.gielen@uzleuven.be.
authors.forename: E
authors.initials: E
authors.lastname: Gielen
authors.forename: T
authors.initials: T
authors.lastname: O'Neill
authors.forename: S
authors.initials: S
authors.lastname: Pye
authors.forename: J
authors.initials: J
authors.lastname: Adams
authors.forename: K
authors.initials: K
authors.lastname: Ward
authors.forename: F
authors.initials: F
authors.lastname: Wu
authors.forename: M
authors.initials: M
authors.lastname: Laurent
authors.forename: F
authors.initials: F
authors.lastname: Claessens
authors.forename: S
authors.initials: S
authors.lastname: Boonen
authors.forename: D
authors.initials: D
authors.lastname: Vanderschueren
authors.forename: S
authors.initials: S
authors.lastname: Verschueren
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D015415:Biomarkers / Q000097:blood; D016723:Bone Remodeling / Q000502:physiology*; D024042:Collagen Type I / Q000097:blood; D005272:Femur Neck / Q000503:physiopathology; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000503:physiopathology; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide