老年男性和女性骨转换标志物与骨体积丢失、骨膜附着及骨折风险的关联：AGES-雷克雅未克纵向研究
Association of bone turnover markers with volumetric bone loss, periosteal apposition, and fracture risk in older men and women: the AGES-Reykjavik longitudinal study.
作者信息
Marques E A, Gudnason V, Lang T, Sigurdsson G, Sigurdsson S, Aspelund T, Siggeirsdottir K, Launer L, Eiriksdottir G, Harris T B
机构信息
Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
Icelandic Heart Association Research Institute, Kópavogur, Iceland.
出版信息
Osteoporos Int. 2016 Dec;27(12):3485-3494. doi: 10.1007/s00198-016-3675-7. Epub 2016 Jun 24.
UNLABELLED
Association between serum bone formation and resorption markers and cortical and trabecular bone loss and the concurrent periosteal apposition in a population-based cohort of 1069 older adults was assessed. BTM levels moderately reflect the cellular events at the endosteal and periosteal surfaces but are not associated with fracture risk.
INTRODUCTION
We assessed whether circulating bone formation and resorption markers (BTM) were individual predictors for trabecular and cortical bone loss, periosteal expansion, and fracture risk in older adults aged 66 to 93 years from the AGES-Reykjavik study.
METHODS
The sample for the quantitative computed tomography (QCT)-derived cortical and trabecular BMD and periosteal expansion analysis consisted of 1069 participants (474 men and 595 women) who had complete baseline (2002 to 2006) and follow-up (2007 to 2011) hip QCT scans and serum baseline BTM. During the median follow-up of 11.7 years (range 5.4-12.5), 54 (11.4 %) men and 182 (30.6 %) women sustained at least one fracture of any type.
RESULTS
Increase in BTM levels was associated with faster cortical and trabecular bone loss at the femoral neck and proximal femur in men and women. Higher BTM levels were positively related with periosteal expansion rate at the femoral neck in men. Markers were not associated with fracture risk.
CONCLUSION
This data corroborates the notion from few previous studies that both envelopes are metabolically active and that BTM levels may moderately reflect the cellular events at the endosteal and periosteal surfaces. However, our results do not support the routine use of BTM to assess fracture risk in older men and women. In light of these findings, further studies are justified to examine whether systemic markers of bone turnover might prove useful in monitoring skeletal remodeling events and the effects of current osteoporosis drugs at the periosteum.
未标记
在一个基于人群的1069名老年人队列中，评估了血清骨形成和骨吸收标志物与皮质骨和小梁骨丢失以及同时发生的骨膜增生之间的关联。骨转换标志物（BTM）水平适度反映了骨内膜和骨膜表面的细胞活动，但与骨折风险无关。
引言
我们评估了来自AGES-雷克雅未克研究的66至93岁老年人中，循环骨形成和骨吸收标志物（BTM）是否是小梁骨和皮质骨丢失、骨膜扩张及骨折风险的个体预测指标。
方法
用于定量计算机断层扫描（QCT）得出的皮质骨和小梁骨密度及骨膜扩张分析的样本包括1069名参与者（474名男性和595名女性），他们有完整的基线（2002年至2006年）和随访（2007年至2011年）髋部QCT扫描及血清基线BTM。在中位随访11.7年（范围5.4 - 12.5年）期间，54名（11.4%）男性和182名（30.6%）女性发生了至少一次任何类型的骨折。
结果
BTM水平升高与男性和女性股骨颈及股骨近端皮质骨和小梁骨的更快丢失相关。较高的BTM水平与男性股骨颈的骨膜扩张率呈正相关。标志物与骨折风险无关。
结论
这些数据证实了先前少数研究的观点，即两个骨膜都是代谢活跃的，并且BTM水平可能适度反映骨内膜和骨膜表面的细胞活动。然而，我们的结果不支持常规使用BTM来评估老年男性和女性的骨折风险。鉴于这些发现，有理由进行进一步研究，以检查骨转换的全身标志物是否可能在监测骨骼重塑事件以及当前骨质疏松药物对骨膜的作用方面有用。
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