Reference Intervals for Bone Turnover Markers in Korean Healthy Women

Cho, Dong Hyeok; Chung, Jin Ook; Chung, Min Young; Cho, Jeong-Ran; Chung, Dong Jin

doi:10.11005/jbm.2020.27.1.43

Cited by 13 publications

(13 citation statements)

References 46 publications

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“…The dose-response-related negative correlation of osteocalcin and handgrip strength in women was in line with previous research conducted by Moriwaki et al [34] Cho et al [35], and Smith et al [21] whose findings showed that the osteocalcin level was higher in women than in men, that it was especially higher in postmenopausal women, and that it was associated with impaired physical performance as osteocalcin levels increased. However, the potential confounders BMI, SMI, and DPP4i use were not adjusted for in previous studies.…”

Section: Discussionsupporting

confidence: 91%

Sex Differences and Positive Dose-Response Relationships between Serum Osteocalcin Levels and Low Muscle Strength

Chen¹,

Lee²,

Chiang³

et al. 2023

Gerontology

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Introduction: Impaired handgrip strength is an indication for sarcopenia and frailty screening, and is associated with increased osteoporotic risks and all-cause mortality. Osteocalcin, secreted by osteoblasts, is a versatile factor that participates in bone turnover and muscle adaptation. The role of osteocalcin in muscle strength has mainly been discussed in animal models and requires more human data. The study aimed to investigate the association between the serum osteocalcin level and handgrip strength in middle-aged individuals and older adults with diabetes. Methods: Adult participants (aged 40 and above, N = 237) with diabetes were enrolled in a medical center in northern Taiwan. Subjects were divided into normal, low muscle mass without dynapenia, dynapenia without low muscle mass, and groups of low muscle mass with dynapenia according to their handgrip strength and muscle mass measurements. Physical performance, including handgrip strength, repeated sit-to-stand tests, walking speed, and short physical performance batteries, was documented. Body composition was measured by bioelectrical impedance analysis. Results: The median serum osteocalcin level was highest in the dynapenic group without low muscle mass (median [Q1, Q3], 14.1 [11.2, 16.3] ng/mL). Multivariate logistic regression showed that a higher serum osteocalcin level was associated with worse handgrip strength (OR: 3.89, 95% CI: 1.66–9.10) after adjusting for body mass index (adiposity), skeletal muscle mass index (muscle), and medication with dipeptidyl peptidase-4 inhibitor. Further sex stratification revealed a more significant association between serum osteocalcin level and impaired handgrip strength in women but not in men. The female groups showed increases in the risk of impaired handgrip strength: 4.84-fold in the osteocalcin T2 group (11.4 ≤ osteocalcin <15.0 ng/mL) and 4.54-fold in the osteocalcin T3 group (osteocalcin ≥15.0 ng/mL). Moreover, after adjusting for various confounders, 8.41-fold and 8.03-fold increases in the risk of impaired handgrip strength were observed in the osteocalcin T2 group (11.4≤ osteocalcin <15.0 ng/mL) and osteocalcin T3 group (osteocalcin ≥14.5 ng/mL), respectively. Conclusion: Higher serum osteocalcin is associated with increased risks of impaired handgrip strength and impaired physical performance. Dose-dependent associations were found especially in postmenopausal women but not in men.

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Section: Discussionsupporting

confidence: 91%

Sex Differences and Positive Dose-Response Relationships between Serum Osteocalcin Levels and Low Muscle Strength

Chen¹,

Lee²,

Chiang³

et al. 2023

Gerontology

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“…Few reference-interval studies on BTMs have been conducted with Asian populations. A Korean study of 287 premenopausal women reported a reference interval for serum CTX (Roche assay) of 101–632 ng/L with a median of 251 ng/L [ 17 ]. Serum PINP concentrations were not measured.…”

Section: Btms During the Life Course In Health And Diseasementioning

confidence: 99%

“…The above consensus statement was based on published studies and suggested universal reference intervals for plasma CTX and PINP concentrations in premenopausal women ( Table 4 ) [ 17 - 20 ]. In contrast, the Korean Society for Bone and Mineral Research consensus statement on the use of BTMs for monitoring osteoporosis treatment provided premenopausal reference intervals for PINP (19–83 µg/L, median: 40 g/L) and CTX (36–899 ng/L, median: 279 ng/L) [ 24 ].…”

Section: Btms During the Life Course In Health And Diseasementioning

confidence: 99%

The Use of Bone-Turnover Markers in Asia-Pacific Populations

Vasikaran,

Thambiah,

Tan

et al. 2023

Ann Lab Med

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Bone-turnover marker (BTM) measurements in the blood or urine reflect the bone-remodeling rate and may be useful for studying and clinically managing metabolic bone diseases. Substantial evidence supporting the diagnostic use of BTMs has accumulated in recent years, together with the publication of several guidelines. Most clinical trials and observational and reference-interval studies have been performed in the Northern Hemisphere and have mainly involved Caucasian populations. This review focuses on the available data for populations from the Asia-Pacific region and offers guidance for using BTMs as diagnostic biomarkers in these populations. The procollagen I N-terminal propeptide and β-isomerized C-terminal telopeptide of type-I collagen (measured in plasma) are reference BTMs used for investigating osteoporosis in clinical settings. Premenopausal reference intervals (established for use with Asia-Pacific populations) and reference change values and treatment targets (used to monitor osteoporosis treatment) help guide the management of osteoporosis. Measuring BTMs that are not affected by renal failure, such as the bone-specific isoenzyme alkaline phosphatase and tartrate-resistant acid phosphatase 5b, may be advantageous for patients with advanced chronic kidney disease. Further studies of the use of BTMs in individuals with metabolic bone disease, coupled with the harmonization of commercial assays to provide equivalent results, will further enhance their clinical applications.

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“…[ 5 ] However, many factors such as individual disease, medication history, and testing protocols are involved in the application of reference values in healthy individuals without osteoporosis to patients with osteoporosis. [ 4 ] Therefore, there are no standards for the monitoring of patients and prediction of fractures using bone markers in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Usefulness of Bone Turnover Marker in Osteoporosis Patients: A Multicenter Study in Korea

Yoo,

Park,

Kim

et al. 2023

J Bone Metab

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Background: This study aimed to investigate real-world data of C-terminal telopeptide (CTX), propeptide of type I collagen (P1NP), and osteocalcin through present multicenter clinical study, and retrospectively analyze the usefulness of bone turnover markers (BTMs) in Koreans. Methods: The study focused on pre- and post-menopausal patients diagnosed with osteoporosis and excluded patients without certain test results or with test intervals of over 1 year. The demographic data and 3 BTMs (CTX, P1NP, and osteocalcin) were collected. The patients were classified by demographic characteristics and the BTM concentrations were analyzed by the group. Results: Among women with no history of fractures, the levels of P1NP (N=2,100) were 43.544±36.902, CTX (N=1,855) were 0.373 ±0.927, and osteocalcin (N=219) were 10.81 ±20.631. Among men with no history of fractures, the levels of P1NP (N=221) were 48.498±52.892, CTX (N=201) were 0.370±0.351, and osteocalcin (N=15) were 7.868 ±10.674. Treatment with teriparatide increased the P1NP levels after 3 months in both men and women, with a 50% increase observed in women. Similarly, treatment with denosumab decreased the CTX levels after 3 months in both men and women, with a reduction of 50% observed in women. Conclusions: The results of this study can contribute to the accurate assessment of bone replacement status in Koreans. We also provide the P1NP level in the Korean population for future comparative studies with other populations.

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Reference Intervals for Bone Turnover Markers in Korean Healthy Women

Cited by 13 publications

References 46 publications

Sex Differences and Positive Dose-Response Relationships between Serum Osteocalcin Levels and Low Muscle Strength

Sex Differences and Positive Dose-Response Relationships between Serum Osteocalcin Levels and Low Muscle Strength

The Use of Bone-Turnover Markers in Asia-Pacific Populations

Effectiveness and Usefulness of Bone Turnover Marker in Osteoporosis Patients: A Multicenter Study in Korea

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