title: Serum levels of the bone turnover markers dickkopf-1, sclerostin, osteoprotegerin, osteopontin, osteocalcin and 25-hydroxyvitamin D in Swedish geriatric patients aged 75 years or older with a fresh hip fracture and in healthy controls.
abstract: BACKGROUND
  Bone turnover markers have a potential clinical use in describing bone remodeling and in predicting fractures.
  
  
  OBJECTIVE
  In an elderly population ≥75 years with a fresh hip fracture, and in healthy controls, investigate bone turnover markers and their relation to each other, to vitamin D status and to bone mineral density (BMD).
  
  
  METHODS
  In a cross-sectional study serum levels of dickkopf-1 (DKK-1), sclerostin (SOST), osteoprotegerin (OPG), osteopontin (OPN), osteocalcin, 25-hydroxyvitamin D (25(OH)D) were analyzed in 89 Swedish patients with a fresh hip fracture and in 82 healthy volunteers. Serum levels of bone markers were determined by Luminex technique.
  
  
  RESULTS
  S-25-hydroxyvitamin D (S-25(OH)D) was decreased in patients compared to controls (48 ± 21 vs. 76 ± 25 nmol/L, p < 0.001). SOST, but none of the other bone turnover markers correlated with BMD (r = 0.50, p < 0.001). Compared with controls, higher levels of OPG (488 ± 1.4 vs. 191 ± 1.4 ng/L, p < 0.001), OPN (69 ± 1.7 vs. 19 ± 1.4 µg/L, p < 0.001), DKK-1 (273 ± 1.7 vs. 168 ± 1.7 ng/L, p < 0.001), and lower levels of osteocalcin (5.8 ± 3.5 vs. 9.5 ± 3.6 µg/L, p < 0.001), were found in the fracture group. Levels of OPG, DKK-1 and SOST in both groups were positively associated. S-25(OH)D concentration was not found to be strongly associated with any of the bone markers.
  
  
  CONCLUSIONS
  In contrast to findings in other studies, we found no strong correlation between 25(OH)D and the investigated bone markers. Both in patients with a fresh hip fracture and in healthy elderly, DKK-1, SOST and OPG appear to be associated. This suggests a relevance in these relationships meriting further investigation.
authors: Section of Endocrinology, Department of Internal Medicine, County Hospital of Kalmar, 391 85, Kalmar, Sweden. PerW@LTKalmar.se.
authors: P
authors: P
authors: Wanby
authors: Department of Orthopedics, County Hospital of Kalmar, Kalmar, Sweden.
authors: R
authors: R
authors: Nobin
authors: Department of Clinical Chemistry, County Hospital of Kalmar, Kalmar, Sweden.
authors: S-P
authors: SP
authors: Von
authors: Department of Clinical Physiology, County Hospital of Kalmar, Kalmar, Sweden.
authors: L
authors: L
authors: Brudin
authors: Department of Clinical Chemistry, County Hospital of Kalmar, Kalmar, Sweden.
authors: M
authors: M
authors: Carlsson
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D015519:Bone Density; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D016723:Bone Remodeling / Q000502:physiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005819:Genetic Markers; D006620:Hip Fractures / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D015675:Osteocalcin / Q000097:blood*; D053495:Osteopontin / Q000097:blood*; D053244:Osteoprotegerin / Q000097:blood*; D013548:Sweden; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; C501126:DKK1 protein, human; D005819:Genetic Markers; D036341:Intercellular Signaling Peptides and Proteins; D053244:Osteoprotegerin; C422903:SOST protein, human; D015675:Osteocalcin; D053495:Osteopontin; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Bone mineral density; DXA; Magpix; Osteoporosis; PTH; Vitamin D deficiency