Reference intervals for bone turnover markers and their association with incident hip fractures in older men: the Health In Men Study

Chubb, S.A. Paul, Byrnes, Elizabeth, Manning, Laurens, Beilby, John P., Ebeling, Peter R., Vasikaran, Samuel D., Golledge, Jonathan, Flicker, Leon, and Yeap, Bu B. (2015) Reference intervals for bone turnover markers and their association with incident hip fractures in older men: the Health In Men Study. Journal of Clinical Endocrinology and Metabolism, 100 (1). pp. 90-99.

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Context: Reference intervals for bone turnover markers (BTMs) and relationships between BTM and fracture risk in older men are not well characterized.

Objective: The purpose of this article was to determine the reference intervals for serum total osteocalcin (tOC), undercarboxylated osteocalcin (ucOC), N-terminal propeptide of type I collagen (PINP), and collagen type I C-terminal cross-linked telopeptide (CTX-I) in healthy older men and to explore factors associated with BTMs, including hip fracture risk.

Participants and Setting: We studied a population-based cohort of 4248 men aged 70 to 89 years, 4008 of whom had serum samples available for analysis.

Interventions: Morning blood samples were collected at the study visit. Comorbid conditions were assessed by questionnaire. The reference sample comprised fasting men (n = 298, median age 75.3 years [interquartile range 73.9–78.1 years) reporting excellent or very good health, without a history of diabetes, cardiovascular disease, cancer, depression, or dementia.

Main Outcome Measures: Serum tOC, PINP, and CTX-I were estimated by automated electrochemiluminescence immunoassays, ucOC was estimated using hydroxyapatite binding, and incident hip fractures were captured from hospital admission data.

Results: Reference intervals for tOC, ucOC, PINP, and CTX-I were 10.2 to 41.0, 5.2 to 21.9, 18 to 129 μg/L, and 117 to 740 ng/L, respectively. tOC, ucOC and CTX-I were associated with hip fracture incidence, but after adjustment for other risk factors only tOC remained significantly associated.

Conclusions: Reference intervals for BTMs in older men have been defined. tOC may be more informative for hip fracture risk in older men than CTX-I and PINP. Further studies are needed to clarify the utility of BTM reference intervals in the management of aging men at risk of osteoporosis.

Item ID: 38916
Item Type: Article (Research - C1)
ISSN: 1945-7197
Funders: National Heart Foundation of Australia, National Health and Medical Research Council of Australia (NHMRC), Queensland Government
Projects and Grants: NHF Grant-in-Aid G11P 5662, NHMRC Project Grant No. 279408, NHMRC Project Grant No. 379600, NHMRC Project Grant No. 403963, NHMRC Project Grant No. 513823, NHMRC Project Grant No. 634492, NHMRC Project Grant No. 1045710, NHMRC Project Grant No. 1060557
Date Deposited: 18 May 2015 23:29
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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