Is the predictive power of previous fractures for new spine and non-spine fractures associated with biochemical evidence of altered bone remodelling? The EPOS study

P Vergnaud, M Lunt, C Scheidt-Nave, G Poor, C Gennari, K Hoszowski, A L Vaz, D M Reid, L Benevolenskaya, S Grazio, K Weber, T Miazgowski, J J Stepan, P Masaryk, F Galan, J B Armas, R Lorenc, S Havelka, R P Cano, M SeibelG Armbrecht, S Kaptoge, T W O'Neill, A J Silman, D Felsenberg, J Reeve, P D Delmas

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: In the European Prospective Osteoporosis Study (EPOS), a past spine fracture increased risk of an incident fracture 3.6-12-fold even after adjusting for BMD. We examined the possibility that biochemical marker levels were associated with this unexplained BMD-independent element of fracture risk. Methods: Each of 182 cases in EPOS of spine or non-spine fracture that occurred in 3.8 years of follow-up was matched by age, sex and study centre with two randomly assigned never-fractured controls and one case of past fracture. Analytes measured blind were: osteocalcin, bone-specific alkaline phosphatase, total alkaline phosphatase, serum creatinine, calcium, phosphate and albumin, together with the collagen cross-links degradation products serum CTS and Urine CTX. Most subjects also had bone density measured by DXA. Results: Cases who had recent fractures did not differ in marker levels from cases who had their last fracture more than 3 years previously. No statistically significant effect of recent fracture was found for any marker except osteocalcin, which was 17.6% lower in recent peripheral cases compared to unfractured controls (p<0.05) and this was independent of BMD. Conclusion: Past fracture as a risk indicator for future fracture is not strongly mediated through increased bone turnover. (C) 2002 Elsevier Science B.V. All rights reserved.

Original languageEnglish
Pages (from-to)121-132
Number of pages12
JournalClinica Chimica Acta
Volume322
Publication statusPublished - 2002

Keywords

  • osteoporosis
  • fractures
  • biochemical markers
  • bone turnover
  • epidemiology
  • bone densitometry
  • EUROPEAN PROSPECTIVE OSTEOPOROSIS
  • INTRACAPSULAR HIP FRACTURE
  • DISTAL FOREARM FRACTURE
  • VERTEBRAL DEFORMITY
  • I COLLAGEN
  • DEGRADATION PRODUCTS
  • POSTMENOPAUSAL WOMEN
  • CANCELLOUS BONE
  • ELDERLY WOMEN
  • RISK

Cite this

Vergnaud, P., Lunt, M., Scheidt-Nave, C., Poor, G., Gennari, C., Hoszowski, K., Vaz, A. L., Reid, D. M., Benevolenskaya, L., Grazio, S., Weber, K., Miazgowski, T., Stepan, J. J., Masaryk, P., Galan, F., Armas, J. B., Lorenc, R., Havelka, S., Cano, R. P., ... Delmas, P. D. (2002). Is the predictive power of previous fractures for new spine and non-spine fractures associated with biochemical evidence of altered bone remodelling? The EPOS study. Clinica Chimica Acta, 322, 121-132.