title: Proportion of Undercarboxylated Osteocalcin and Serum P1NP Predict Incidence of Myocardial Infarction in Older Men.
abstract: BACKGROUND
  Undercarboxylated osteocalcin (ucOC) modulates insulin secretion and sensitivity in mice, and higher ucOC is associated with lower prevalence of diabetes in men. The influence of ucOC distinct from other markers of bone turnover on incidence of cardiovascular events is unclear.
  
  
  METHODS
  Community-dwelling men aged 70-89 years resident in Perth, Western Australia.
  
  
  METHODS
  Serum total osteocalcin (TOC), N-terminal propeptide of type I collagen (P1NP), and collagen type I C-terminal cross-linked telopeptide (CTX) were measured by immunoassay, and ucOC by hydroxyapatite binding. The ratio ucOC/TOC was calculated. Hospital admissions and deaths from myocardial infarction (MI) and stroke were ascertained.
  
  
  RESULTS
  There were 3384 men followed for 7.0 years, during which 293 experienced an MI, 251 stroke, and 2840 neither. In multivariate analyses, higher ratio of ucOC/TOC (expressed as %) was associated with lower incidence of MI (quartiles Q2-4, ≥ 49% versus Q1,<49%, hazard ratio 0.70, 95% confidence interval = 0.54-0.91), but not of stroke (0.99, 0.73-1.34). Higher P1NP was associated with higher incidence of MI (Q2-4, ≥ 28.2 μg/L versus Q1, <28.2 μg/L, hazard ratio 1.45, 95% confidence interval = 1.06-1.97), but not of stroke (0.94, 0.70-1.26). CTX was not associated with incident MI or stroke.
  
  
  CONCLUSIONS
  A reduced proportion of undercarboxylated osteocalcin or higher P1NP are associated with increased incidence of MI. UcOC/TOC ratio and P1NP predict risk of MI but not stroke, in a manner distinct from CTX. Further studies are needed to investigate potential mechanisms by which bone turnover markers related to metabolic risk and to collagen formation could modulate cardiovascular risk.
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Bu B
authors: BB
authors: Yeap
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Helman
authors: H
authors: Alfonso
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: S A Paul
authors: SA
authors: Chubb
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Elizabeth
authors: E
authors: Byrnes
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: John P
authors: JP
authors: Beilby
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Peter R
authors: PR
authors: Ebeling
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Carolyn A
authors: CA
authors: Allan
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Carl
authors: C
authors: Schultz
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Graeme J
authors: GJ
authors: Hankey
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Jonathan
authors: J
authors: Golledge
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Leon
authors: L
authors: Flicker
authors: School of Medicine and Pharmacology (B.B.Y., S.A.P.C., C.S., G.J.H., L.F.), University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes (B.B.Y.), Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Public Health (H.A.), Curtin University, Perth, Western Australia, Australia; PathWest Laboratory Medicine (S.A.P.C., E.B., J.P.B.), Fiona Stanley, Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia, Australia; Department of Medicine (P.R.E.), School for Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Monash Institute of Medical Research (C.A.A.), Prince Henry's Research Institute, Melbourne, Victoria, Australia; Department of Cardiology (C.S.), Royal Perth Hospital, Perth, Western Australia, Australia; Vascular Biology Unit (J.G.), Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Queensland, Australia; Department of Vascular and Endovascular Surgery (J.G.), The Townsville Hospital, Townsville, Queensland, Australia; Western Australian Centre for Health and Ageing (L.F.), Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia; School of Surgery (P.E.N.), University of Western Australia, Perth, Western Australia, Australia.
authors: Paul E
authors: PE
authors: Norman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D024042:Collagen Type I / Q000097:blood; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology*; D015675:Osteocalcin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood*; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology
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; D015675:Osteocalcin