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Bone turnover markers predict later bone loss in healthy men
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Among healthy men aged 25 to 45 years, higher levels of bone turnover markers predict greater decreases in areal bone mineral density 12 years later, according to a population-based study conducted in Belgium.
“After peak bone mass attainment, serum levels of bone turnover markers decrease rapidly in women only to rise again during and after the menopause transition, whereas they remain remarkably high in men, not reaching nadir until the fifth or sixth decade of life,” Charlotte Verroken, MD, of the department of endocrinology and metabolic bone diseases at Ghent University Hospital in Belgium, and colleagues wrote in the study background. “The underlying mechanisms and clinical significance of these persistently high levels of bone turnover in young adult men are incompletely understood.”
Verroken and colleagues analyzed data from 973 healthy men aged 25 to 45 years, who had a brother in the same age range willing to participate, recruited from communities around Ghent, Belgium, between March 2002 and July 2010. In October 2016, 417 men in the cohort were re-evaluated.
At baseline and follow-up, participants completed questionnaires regarding medical history, calcium intake and physical activity, and provided fasting blood samples to measure bone turnover markers, including procollagen type 1 N-terminal propeptide (P1NP), osteocalcin and C-terminal telopeptide of type 1 collagen (CTX). Body composition, areal bone parameters and areal BMD at the total body, lumbar spine and left proximal femur were assessed via DXA. The cohort was followed for a mean of 12.4 years.
Within the cohort, mean values were 2.69 for work index, 2.67 for sports index and 2.68 for leisure time index. Median daily calcium intake was 563 mg, and 55.1% had a normal BMI.
Researchers found that bone turnover markers were positively associated with total body lean mass and sports index scores, but were inversely associated with total body fat mass. Total physical activity, work index or leisure time index were not associated with burn turnover markers (P .075 for all).
Additionally, higher baseline levels of osteocalcin and CTX were associated with larger decreases in areal BMD and bone mineral content at all sites at follow-up, whereas higher baseline levels of P1NP were associated with larger decreases at the total hip and spine. Models that included an additional bone turnover marker increased the explained proportion of variance in areal BMD and bone mineral content changes up to 8%, with the largest increases for models including CTX, according to the researchers.
Results persisted after adjustment for baseline sports index score and parathyroid hormone levels. There were no interactions observed between bone turnover markers and baseline age for any sites measured by DXA.
“Bone turnover at this age is an important determinant of subsequent bone changes, with higher levels of bone turnover markers being associated with greater decreases in [areal] BMD at several skeletal sites over a 12-year period,” the researchers wrote. “Thus, whereas high levels of bone turnover may lead to larger increases in bone mass during growth, our findings suggest that around peak bone mass age, they predict a more rapid bone loss.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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