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Bone turnover markers fail to predict hip fracture in postmenopausal women
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Among postmenopausal women, two key bone turnover markers do not independently predict hip fracture risk after controlling for several factors, including fall history, BMI, and vitamin D and calcium intake, according to findings presented at the North American Menopause Society annual meeting.
“Serum C-terminal telopeptide of type I collagen [CTX] and serum procollagen type 1 N-terminal propeptide [P1NP] testing is not useful for predicting hip fracture risk for women in this age group,” Carolyn J. Crandall, MD, MS, professor of medicine in the division of internal medicine at the David Geffen School of Medicine at UCLA, told Endocrine Today. “The results cannot be generalized to men, people taking osteoporosis medication, or other types of fractures.”
In a nested, case-control analysis of postmenopausal women participating in the Women’s Health Initiative study, Crandall and colleagues assessed levels of CTX and serum P1NP in 12-hour fasting blood samples. Cases were women with incident hip fracture not taking antiosteoporosis medications (n = 400), and controls were untreated women matched for age, race and date of blood sampling (n = 400). Main outcome measure was incident hip fracture risk. Mean follow-up for the cohort was 7.13 years.
Researchers found that CTX was not associated with hip fracture risk (P for trend = .22), nor was P1NP (P for trend = .53). Across CTX quartiles, hip fracture-risk women with the highest serum concentration ( 0.51 ng/mL) did not rise to statistical significance vs. women in the lowest quartile (< 0.28 ng/mL), with an adjusted OR of 1.25 (95% CI, 0.68-2.3). Similarly, across quartiles for P1NP levels, hip fracture-risk women with the highest serum concentration ( 59.2 ng/mL) did not rise to statistical significance vs. women in the lowest quartile (< 35.66 ng/mL), with an adjusted OR of 1.24 (95% CI, 0.65-2.35).
“Our results do not support the utility of serum CTX level or P1NP level to independently predict hip fracture risk in women in this age group,” the researchers wrote in an abstract. “These results will inform future guidelines regarding the potential utility of these markers in fracture prediction.” – by Regina Schaffer
Reference:
Crandall CJ, et al. Abstract S-13. Presented at: North American Menopause Society Annual Meeting; Oct. 3-6, 2018; San Diego.
For more information:
Carolyn J. Crandall, MD, MS, can be reached at the David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095; email: ccrandall@mednet.ucla.edu.
Disclosures: The authors report no relevant financial disclosures.