Serum osteocalcin and fracture susceptibility in elderly women

Abstract

The purpose of this investigation was to evaluate the bone turnover by using bone metabolic markers in relation to previous fracture history and independent of bone mass. Patients and controls were recruited from a population-based study of 193 women, all living in the same city and aged 60, 70, and 80 years. The bone mineral content (BMC) was measured bilaterally in the distal forearm by single-photon absorptiometry (SPA). At the same time, serum samples were obtained for biochemical analysis. Of the 193 women, we identified 26 with at least one major fracture during the past few years. Each of these 26 women with a certified recent previous fracture was individually matched with a woman from the same study group of equal BMC and age but without a fracture history. In the two groups, the serum samples were analyzed for osteocalcin, C-terminal procollagen peptide (P1CP), alkaline phosphatase, bone-specific alkaline phosphatase, calcium, phosphate, and albumin. The serum concentration of osteocalcin was 20% lower in the women with a previous fracture than in the controls (P = 0.03). The other markers of bone formation gave similar values in the two groups. There was a significant correlation between the osteocalcin and P1CP concentrations (P = 0.001). Our findings indicate that the susceptibility to fractures independent of factors such as age and BMC may be related to a decreased bone turnover.

Markers of Bone Turnover for the Prediction of Fracture Risk

“…However, no signi®cant association was found for total ALP, bone ALP and for procollagen type I C propeptide (PICP) [11,12]. Similar results were reported by Akesson et al [13] in a small case±control analysis, with 19% lower OC levels in 26 women who had sustained a fracture 2.8 years before the measurement compared with 26 age-matched controls. Luisitto et al [14] also reported a slight but signi®cant decrease in OC (710%) and a more pronounced decrease in total ALP (740%) in 100 women who sustained vertebral and nonvertebral fractures more than 1 year before measurement compared with 219 control subjects.…”

Clinical application of biochemical markers of bone turnover

“…It is now widely accepted that the accelerated rate of bone loss seen after the menopause is mainly due to an uncoupling in bone turnover and an increase in bone resorption (26,27). Studies employing specific bone markers indicate that bone turnover continues to be increased (and to be associated with bone loss) during late menopause (28)(29)(30)(31)(32)(33). In some postmenopausal women (34), but particularly in the very elderly (35)(36)(37), this increase in bone turnover is often, but not always, found to be due to vitamin D and/or calcium deficiency and secondary hyperparathyroidism.…”

“…In retrospective population-based studies, Akesson and co-workers (28,29,43,44) have demonstrated that previous fractures were associated with abnormal bone turnover. After adjustment for age and BMD, women with fractures occurring within six years prior to the study were characterised by lower serum levels of OC and PICP, but normal rates of bone resorption.…”

Effect of Resistance Exercise Training on Bone Formation and Resorption in Young Male Subjects Assessed by Biomarkers of Bone Metabolism

“…Other markers, such as plasma procollagen type‐I C‐terminal (PICP) and serum bone‐specific alkaline phosphatase (B‐ALP) are also considered to be the indicators of bone formation. There seems to be a divergent response among these markers of bone formation in various diseases (17,18) . The various markers may therefore reflect different stages of the osteoblastic development and function.…”