骨转换生化标志物与老年女性髋部骨折发病风险：心血管健康研究。
Biochemical markers of bone turnover and risk of incident hip fracture in older women: the Cardiovascular Health Study.
机构信息
New York University School of Medicine, New York, NY, USA.
Albert Einstein College of Medicine, Bronx, NY, USA.
出版信息
Osteoporos Int. 2019 Sep;30(9):1755-1765. doi: 10.1007/s00198-019-05043-1. Epub 2019 Jun 21.
UNLABELLED
The relationships of osteocalcin (OC) and C-telopeptide of type I collagen (CTX) with long-term incidence of hip fracture were examined in 1680 post-menopausal women from a population-based study. CTX, but not OC, levels were associated with incident hip fracture in these participants, a relationship characterized by an inverted U-shape.
INTRODUCTION
We sought to investigate the relationships of OC, a marker of bone formation, and CTX, a marker of bone resorption, with long-term incidence of hip fracture in older women.
METHODS
We included 1680 women from the population-based Cardiovascular Health Study (mean [SD] age 74.5 [5.0] years). The longitudinal association of both markers with incidence of hip fracture was examined using multivariable Cox models.
RESULTS
During a median follow-up of 12.3 years, 288 incident hip fractures occurred. Linear spline analysis did not demonstrate an association between OC levels and incident hip fracture. By contrast, increasing levels of CTX up to the middle-upper range were associated with a significantly greater risk of hip fracture (HR = 1.52 per SD increment, 95% CI = 1.10-2.09), while further increases were associated with a marginally non-significant lower risk (HR = 0.80 per SD increment, 95% CI = 0.63-1.01), after full adjustment for potential confounders. In analyses of quartiles, CTX exhibited a similar inverted U-shaped relationship with incident fracture after adjustment, with a significant association observed only for the comparison of quartile 3 to quartile 1 (HR = 1.63, 95% CI = 1.10-2.43). In a subset with available measures, both OC and CTX were inversely associated with bone mineral density of the hip.
CONCLUSION
CTX, but not OC, levels were associated with incident hip fracture in post-menopausal women, a relationship characterized by an inverted U-shape. These findings highlight the complex relationship of bone turnover markers with hip fracture risk.
未加标签
本研究在一项基于人群的研究中，检查了骨钙素 (OC) 和 I 型胶原 C-末端肽 (CTX) 与绝经后妇女长期髋部骨折发生率的关系。CTX 水平与这些参与者的髋部骨折事件相关，但 OC 水平与髋部骨折事件无关，两者的关系呈倒 U 型。
引言
我们试图研究骨形成标志物 OC 和骨吸收标志物 CTX 与老年女性长期髋部骨折发生率的关系。
方法
我们纳入了来自基于人群的心血管健康研究的 1680 名女性（平均 [标准差] 年龄 74.5 [5.0] 岁）。使用多变量 Cox 模型检查两种标志物与髋部骨折发生率的纵向关联。
结果
在中位随访 12.3 年期间，发生了 288 例髋部骨折事件。线性样条分析未显示 OC 水平与髋部骨折事件之间存在关联。相比之下，CTX 水平在中高水平上逐渐增加与髋部骨折风险显著增加相关（每 SD 增量的 HR=1.52，95%CI=1.10-2.09），而进一步增加则与风险略有非显著降低相关（每 SD 增量的 HR=0.80，95%CI=0.63-1.01），在充分调整潜在混杂因素后。在四分位数分析中，CTX 与骨折事件呈相似的倒 U 型关系，在调整后具有统计学意义，仅在第 3 四分位数与第 1 四分位数相比时观察到这种关联（HR=1.63，95%CI=1.10-2.43）。在有可用指标的亚组中，OC 和 CTX 均与髋部骨密度呈负相关。
结论
CTX 水平与绝经后妇女髋部骨折事件相关，但 OC 水平与髋部骨折事件无关，两者的关系呈倒 U 型。这些发现突出了骨转换标志物与髋部骨折风险之间复杂的关系。
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