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Bone turnover markers predict hip bone loss in elderly European men: results of the European Male Ageing Study (EMAS)

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Abstract

Summary

The aim of this study was to determine whether bone turnover markers (BTMs) predict changes in areal bone mineral density (aBMD) in middle-aged and elderly European men. Older men with high bone turnover are at a higher risk of accelerated hip bone loss, but the clinical utility of BTMs in individuals is limited.

Introduction

Prospective studies on the value of BTMs to predict changes in aBMD in men are few and conflicting. The aim of this study was to determine whether BTMs predict changes in aBMD in middle-aged and elderly European men.

Methods

In 487 men aged 40–79 years from the European Male Ageing Study (EMAS), BTMs were assessed at baseline and dual-energy X-ray absorptiometry (DXA) at the lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed at baseline and after a mean follow-up of 4.3 years.

Results

The mean aBMD decreased by 0.32 %/year at FN and 0.22 %/year at TH and increased by 0.32 %/year at LS. Higher baseline levels of β C-terminal cross-linked telopeptide (β-CTX) and N-terminal propeptide of type I procollagen (PINP) were significantly associated with higher loss of hip aBMD in the whole cohort and men aged 60–79 years. These associations remained significant after adjustment for age, centre and body mass index (BMI). Men aged 60–79 years with β-CTX in the upper quintile were more likely of being in the upper quintile of annual percentage (%) aBMD loss at FN (OR = 4.27; 95% CI = 2.09–8.73) and TH (OR = 3.73; 95% CI = 1.84–7.57). The positive predictive value (PPV) was 46 % at both hip sites.

Conclusion

Older men with high bone turnover have a higher risk of accelerated hip bone loss, but the PPV is low. BTMs are therefore unlikely to be of clinical utility in predicting accelerated hip bone loss in individual subjects.

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Acknowledgments

This work is dedicated to the memory of Prof. Dr. Steven Boonen.

The European Male Ageing Study (EMAS) was funded by the Commission of the European Communities Fifth Framework Programme Quality of Life and Management of Living Resources grant QLK6-CT-2001-00258. This work was also supported by grant G.0488.08 from the Fund for Scientific Research (FWO-Vlaanderen) to SB, research grants OT-05-53, OT-09-035 and OT-11-081 from the KU Leuven to DV and research funding from Arthritis Research UK. DV is a senior clinical investigator of the Leuven University Hospital Clinical Research Fund. ML is a fellow of the Research Foundation Flanders. KW is funded by the UK Medical Research Council, programme number U105960371.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium

    E. Gielen, M. Laurent & S. Boonen

  2. Centre for Metabolic Bone Diseases, UZ Leuven, Leuven, Belgium

    E. Gielen, M. Laurent, S. Boonen & D. Vanderschueren

  3. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK

    T. O’Neill & S. Pye

  4. Manchester Academic Health Science Centre (MAHSC) and Radiology at Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK

    J. Adams

  5. Nutrition and Bone Health, Medical Research Council Human Nutrition Research, Cambridge, UK

    K. Ward

  6. Andrology Research Unit, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK

    F. Wu

  7. Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

    M. Laurent & F. Claessens

  8. Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium

    D. Vanderschueren

  9. Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium

    S. Verschueren

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  1. E. Gielen
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  10. D. Vanderschueren
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Correspondence to E. Gielen.

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Gielen, E., O’Neill, T., Pye, S. et al. Bone turnover markers predict hip bone loss in elderly European men: results of the European Male Ageing Study (EMAS). Osteoporos Int 26, 617–627 (2015). https://doi.org/10.1007/s00198-014-2884-1

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