A Meta-Analysis of Reference Markers of Bone Turnover for Prediction of Fracture

The aim of this report was to summarize the clinical performance of two reference bone turnover markers (BTMs) in the prediction of fracture risk. We used an updated systematic review to examine the performance characteristics of serum procollagen type I N propeptide (s-PINP) and serum C-terminal cr...

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Bibliographic Details
Published inCalcified tissue international Vol. 94; no. 5; pp. 560 - 567
Main Authors Johansson, Helena, Odén, Anders, Kanis, John A., McCloskey, Eugene V., Morris, Howard A., Cooper, Cyrus, Vasikaran, Samuel
Format Journal Article
LanguageEnglish
Published Boston Springer US 01.05.2014
Springer Nature B.V
Subjects
Biochemistry
Biomarkers - blood
Biomedical and Life Sciences
Bone Remodeling - physiology
Cell Biology
Collagen
Endocrinology
Fractures
Fractures, Bone - blood
Humans
Life Sciences
Meta-analysis
Original Research
Orthopedics
Risk Factors
Marker of bone turnover
Fracture
Serum procollagen type I N propeptide
Serum carboxy-terminal cross-linking telopeptide of type I collagen
Meta-analysis
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Summary:The aim of this report was to summarize the clinical performance of two reference bone turnover markers (BTMs) in the prediction of fracture risk. We used an updated systematic review to examine the performance characteristics of serum procollagen type I N propeptide (s-PINP) and serum C-terminal cross-linking telopeptide of type I collagen (s-CTX) in fracture risk prediction in untreated individuals in prospective cohort studies. We excluded cross-sectional studies. Ten potentially eligible publications were identified and six included in the meta-analysis. There was a significant association between s-PINP and the risk of fracture. The hazard ratio per SD increase in s-PINP (gradient of risk [GR]) was 1.23 (95 % CI 1.09–1.39) for men and women combined unadjusted for bone mineral density. There was also a significant association between s-CTX and risk of fracture, GR = 1.18 (95 % CI 1.05–1.34) unadjusted for bone mineral density. For the outcome of hip fracture, the association between s-CTX and risk of fracture was slightly higher, 1.23 (95 % CI 1.04–1.47). Thus, there is a modest but significant association between BTMs and risk of future fractures.
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ISSN:0171-967X
1432-0827
DOI:10.1007/s00223-014-9842-y