The Tromsø Study: A Population-Based Study on the Variation in Bone Formation Markers with Age, Gender, Anthropometry and Season in both Men and Women

Abstract

Background information on how biological factors influence the level of bone turnover markers is crucial in order to make proper use of these measurements. In the present study, which is part of the fourth survey of a general population in Tromsø, Norway, we evaluated the variation in the bone formation markers bone alkaline phosphatase (S-BAP) and osteocalcin (S-OC) in 528 men and 605 women, age 25-74 years. In the Tromsø Study in 1994/5, the whole population above 25 years was initially invited and 7948 individuals attended an extended examination (76.4% of the invited population). The present study population is a random sample of these attendees. The variation with age, gender, height, weight, body mass index and season, and with menopausal status in women, was examined. In men there was a decrease in S-OC up to the age of 56 years with little further change, while S-BAP showed no change with age. Among women, variation in bone markers was mainly observed to change with menopause, with a 41% and 21% increase in the mean level of S-BAP and S-OC, respectively. There was a negative trend in S-OC with body mass index in both men and women. A seasonal change of 20% in the level of both bone markers in men and of S-BAP in postmenopausal women was observed in this region at a far northern latitude. We conclude that, of the factors examined, season and menopausal status must be taken into account when measuring these bone formation markers.

Clinical application of biochemical markers of bone turnover

“…The rate of bone loss is determined by a number of factors, one of which appears to be the rate of bone remodelling. Earlier observations demonstrated that bone formation and bone resorption increase shortly after natural menopause; a phase that in most women is also associated with significantly accelerated bone loss (4,5,(8)(9)(10)(11)(12)(13)(14). Similar observations have been made in ovariectomized, premenopausal women and in castrated men (56,57), indicating that the withdrawal of endogenous sex steroid induces both high bone turnover and rapid bone loss.…”

“…After that, a slight increase is usually seen in both formation and resorption markers (4-7). In contrast, menopause is associated with a substantial acceleration in bone turnover, mirrored by a 50-100% increase in both markers of bone formation and resorption (4,5,(8)(9)(10)(11)(12)(13)(14). In early postmenopausal women, this increase in bone turnover can be attenuated by oral calcium supplementation (15)(16)(17)(18)(19).…”

Serum Osteocalcin Level in Type 2 Diabetes and Its Relation to the Severity of Coronary Heart Disease, Insulin Resistance and High Sensitive-CRP

“…(20)(21)(22) There may be other factors influencing serum osteocalcin concentrations such as the use of oral contraceptives (23,24) hormone replacement therapy (25) and BMI. (26) Furthermore, serum osteocalcin concentrations were reported to be increased for short term by calcium intake.…”

The Influence of Age, Ethnicity and Body Anthropometry on the Level of Serum Osteocalcin and Terminal-C Telopeptides of Type I Collagen in Men

“…Terdapat percanggahan pendapat dalam pola perubahan PPT berdasarkan umur dalam kalangan lelaki. Pola perubahan berbentuk penurunan linear (Wishart et al 1995), dua fasa ataupun quadratik (Midtby et al 2001;Szulc et al 2001) telah dilaporkan. Kewujudan perbezaan pada aras PPT di antara kumpulan etnik masih dipertikaikan kerana kehadiran dan ketidakhadiran perbezaan tersebut pernah dilaporkan (Henry & Eastell 2000;Leder et al 2007).…”

“…Walau bagaimanapun, aras PPT paling rendah biasanya dijumpai pada umur yang lebih lewat menurut kajian lain berbanding dengan kajian ini. Midtby et al (2001) mendapati dalam kalangan lelaki berumur 25-74 tahun yang menyertai Kajian Tromso, aras OC mengikut umur adalah berbentuk quadratik dengan titik nadir pada 56 tahun (Midtby et al 2001). Kajian Szulc et al (2001) juga mendapati taburan quadratik pada aras OC dalam kalangan lelaki 18-85 tahun dengan titik nadir pada 56-60 tahun (Szulc et al 2001).…”