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Published in: Osteoporosis International 1/2017

01-01-2017 | Original Article

The levels of bone turnover markers 25(OH)D and PTH and their relationship with bone mineral density in postmenopausal women in a suburban district in China

Authors: C. Gao, J. Qiao, S. S. Li, W. J. Yu, J. W. He, W. Z. Fu, Z. L. Zhang

Published in: Osteoporosis International | Issue 1/2017

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Abstract

Summary

This study evaluated the levels of bone turnover markers (BTMs) and investigated relationships between them and bone mineral density (BMD) in postmenopausal women in China suburban district. The prevalence of osteoporosis was 25.03 % at lumbar spine and 6.23 % at femoral neck, and BTMs were negatively correlated with BMDs.

Introduction

The aims of this study were to evaluate the levels of bone turnover markers (BTMs), including serum N-terminal procollagen of type I collagen (P1NP), beta C-terminal cross-linked of type I collagen (β-CTX), 25-hydroxyvitamin D [25(OH)D], and parathyroid hormone (PTH), and to investigate relationships between these markers and bone mineral density (BMD) as well the prevalence of osteoporosis in postmenopausal women of suburban district.

Methods

A population of 4822 postmenopausal women aged 55–69 years old (62.22 ± 6.75) from the suburban district was recruited voluntarily. BMD was measured at the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry; 2251 women in this group had the serum BTMs 25(OH)D and PTH tested.

Results

The prevalence of osteoporosis was 25.03 % at lumbar spine and 6.23 % at femoral neck. The median (interquartile range) values of serum P1NP, β-CTX, 25(OH)D, and PTH were 59.3 ng/mL (44.7–75.52), 0.370 ng/mL (0.280–0.490), 23.0 ng/mL (17.1–30.5), and 31.4 pg/mL (24.9–39.7), respectively. Serum P1NP and β-CTX levels presented significantly negative correlations with BMDs at the all the sites (Betastd = −0.098 to −0.208, respectively, P < 0.001), whereas PTH levels were negatively correlated with BMDs of the femoral neck and total hip (Betastd = −0.062 and −0.054, P < 0.01, respectively). Serum 25(OH)D had positive associations with BMDs at total hip (Betastd = 0.051, P < 0.01).

Conclusions

The BMD of postmenopausal women in China suburban area is higher than that in downtown area, and over 60 % of the participants had their serum 25(OH)D level over 20 ng/mL. BTMs were negatively correlated with BMDs, suggesting that BTMs are reliable factors for early declines in BMD.
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Literature
1.
go back to reference (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Osteoporos Int. 1:114–117 (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Osteoporos Int. 1:114–117
2.
go back to reference Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34:195–202CrossRefPubMed Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34:195–202CrossRefPubMed
3.
go back to reference Fagerlund KM, Halleen JM (2009) Bone turnover markers and their application in clinical practice. Chin J Osteoporos Bone Miner Res 2:73–78 Fagerlund KM, Halleen JM (2009) Bone turnover markers and their application in clinical practice. Chin J Osteoporos Bone Miner Res 2:73–78
4.
go back to reference Singer FR, Eyre DR (2008) Using biochemical markers of bone turnover in clinical practice. Cleve Clin J Med 75:739–750CrossRefPubMed Singer FR, Eyre DR (2008) Using biochemical markers of bone turnover in clinical practice. Cleve Clin J Med 75:739–750CrossRefPubMed
5.
go back to reference Kumar R, Thompson JR (2011) The regulation of parathyroid hormone secretion and synthesis. J Am Soc Nephrol 22:216–224CrossRefPubMed Kumar R, Thompson JR (2011) The regulation of parathyroid hormone secretion and synthesis. J Am Soc Nephrol 22:216–224CrossRefPubMed
6.
go back to reference Nakamura K, Saito T, Oyama M, Oshiki R, Kobayashi R, Nishiwaki T, Nashimoto M, Tsuchiya Y (2011) Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study. Osteoporos Int 22:97–103CrossRefPubMed Nakamura K, Saito T, Oyama M, Oshiki R, Kobayashi R, Nishiwaki T, Nashimoto M, Tsuchiya Y (2011) Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study. Osteoporos Int 22:97–103CrossRefPubMed
7.
go back to reference Shanghai Municipal Statistics Bureau, Survey Office of the National Bureau of Statistics in Shanghai (2015) Shanghai Statistical Yearbook 2014. Shanghai Shanghai Municipal Statistics Bureau, Survey Office of the National Bureau of Statistics in Shanghai (2015) Shanghai Statistical Yearbook 2014. Shanghai
8.
go back to reference Shanghai Pudong New Area Statistics Bureau, Pudong Survey Team of National Statistics Bureau (2015) Shanghai Pudong New Area Statistical Yearbook 2014. Shanghai Shanghai Pudong New Area Statistics Bureau, Pudong Survey Team of National Statistics Bureau (2015) Shanghai Pudong New Area Statistical Yearbook 2014. Shanghai
9.
go back to reference Huang QR, Zhou Q, Lu JH, Hu YQ, Liu YJ, Qin YJ, Ma JX, Li M (2002) Bone mineral density and age-related bone loss in 2111 healthy women in Shanghai. Chin J Osteoporos 8:191–194 Huang QR, Zhou Q, Lu JH, Hu YQ, Liu YJ, Qin YJ, Ma JX, Li M (2002) Bone mineral density and age-related bone loss in 2111 healthy women in Shanghai. Chin J Osteoporos 8:191–194
10.
go back to reference Zhang H, Shan PF, Luo XH, Wu XP, Liao EY (2006) Prospective investigation of annual bone loss rate in females in Changsha city, Hunan province. Zhonghua yi xue za zhi 86:2986–2989PubMed Zhang H, Shan PF, Luo XH, Wu XP, Liao EY (2006) Prospective investigation of annual bone loss rate in females in Changsha city, Hunan province. Zhonghua yi xue za zhi 86:2986–2989PubMed
11.
go back to reference Hou YL, Liao EY, Wu XP, Peng YQ, Zhang H, Dai RC, Luo XH, Cao XZ (2008) Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis. Osteoporos Int 19:71–78CrossRefPubMed Hou YL, Liao EY, Wu XP, Peng YQ, Zhang H, Dai RC, Luo XH, Cao XZ (2008) Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis. Osteoporos Int 19:71–78CrossRefPubMed
12.
go back to reference Cheng Q, Zhao XY, Zhang XM, Li HL, Du YP, Zhu HM (2012) Age and sex effects on the association between body composition and bone mineral density in healthy Chinese men and women. Menopause (New York, NY) 19:448–55CrossRef Cheng Q, Zhao XY, Zhang XM, Li HL, Du YP, Zhu HM (2012) Age and sex effects on the association between body composition and bone mineral density in healthy Chinese men and women. Menopause (New York, NY) 19:448–55CrossRef
13.
go back to reference Martin Jimenez JA, Consuegra Moya B, Martin Jimenez MT (2015) [Nutritional factors in preventing osteoporosis]. Nutr Hosp 32 Suppl 1:49–55PubMed Martin Jimenez JA, Consuegra Moya B, Martin Jimenez MT (2015) [Nutritional factors in preventing osteoporosis]. Nutr Hosp 32 Suppl 1:49–55PubMed
14.
go back to reference Zhou XW, Wu XY, Luo L, Guo LJ, Lei MX, Zhang H, Xie H, Peng YQ, Wu XP, Liao EY (2011) The relationship between bone turnover markers and BMD decreasing rates in Chinese middle-aged women. Clin Chim Acta 412:1648–1657CrossRefPubMed Zhou XW, Wu XY, Luo L, Guo LJ, Lei MX, Zhang H, Xie H, Peng YQ, Wu XP, Liao EY (2011) The relationship between bone turnover markers and BMD decreasing rates in Chinese middle-aged women. Clin Chim Acta 412:1648–1657CrossRefPubMed
15.
go back to reference Lu HK, Zhang Z, Ke YH, He JW, Fu WZ, Zhang CQ, Zhang ZL (2012) High prevalence of vitamin D insufficiency in China: relationship with the levels of parathyroid hormone and markers of bone turnover. PLoS One 7:e47264CrossRefPubMedPubMedCentral Lu HK, Zhang Z, Ke YH, He JW, Fu WZ, Zhang CQ, Zhang ZL (2012) High prevalence of vitamin D insufficiency in China: relationship with the levels of parathyroid hormone and markers of bone turnover. PLoS One 7:e47264CrossRefPubMedPubMedCentral
16.
go back to reference Song BB, Wu J, Zhang CY, Jin J, Zhu J, Guo W, Pan BS (2009) Serum bone turnover markers reference intervals establishment in population of Shanghai. Chin J Lab Med 32:1161–65 Song BB, Wu J, Zhang CY, Jin J, Zhu J, Guo W, Pan BS (2009) Serum bone turnover markers reference intervals establishment in population of Shanghai. Chin J Lab Med 32:1161–65
17.
go back to reference Zhao J, Xia W, Nie M et al (2011) The levels of bone turnover markers in Chinese postmenopausal women: Peking Vertebral Fracture study. Menopause (New York, NY) 18:1237–1243CrossRef Zhao J, Xia W, Nie M et al (2011) The levels of bone turnover markers in Chinese postmenopausal women: Peking Vertebral Fracture study. Menopause (New York, NY) 18:1237–1243CrossRef
18.
go back to reference Hu WW, Zhang Z, He JW, Fu WZ, Wang C, Zhang H, Yue H, Gu JM, Zhang ZL (2013) Establishing reference intervals for bone turnover markers in the healthy Shanghai population and the relationship with bone mineral density in postmenopausal women. Int J Endocrinol 2013:513925PubMedPubMedCentral Hu WW, Zhang Z, He JW, Fu WZ, Wang C, Zhang H, Yue H, Gu JM, Zhang ZL (2013) Establishing reference intervals for bone turnover markers in the healthy Shanghai population and the relationship with bone mineral density in postmenopausal women. Int J Endocrinol 2013:513925PubMedPubMedCentral
19.
go back to reference Martinez J, Olmos JM, Hernandez JL, Pinedo G, Llorca J, Obregon E, Valero C, Gonzalez-Macias J (2009) Bone turnover markers in Spanish postmenopausal women: the Camargo cohort study. Clin Chim Acta 409:70–74CrossRefPubMed Martinez J, Olmos JM, Hernandez JL, Pinedo G, Llorca J, Obregon E, Valero C, Gonzalez-Macias J (2009) Bone turnover markers in Spanish postmenopausal women: the Camargo cohort study. Clin Chim Acta 409:70–74CrossRefPubMed
20.
go back to reference Boudou P, Ibrahim F, Cormier C, Sarfati E, Souberbielle JC (2009) Potential utility of high preoperative levels of serum type I collagen markers in postmenopausal women with primary hyperparathyroidism with respect to their short-term variations after parathyroidectomy. J Bone Miner Metab 27:240–246CrossRefPubMed Boudou P, Ibrahim F, Cormier C, Sarfati E, Souberbielle JC (2009) Potential utility of high preoperative levels of serum type I collagen markers in postmenopausal women with primary hyperparathyroidism with respect to their short-term variations after parathyroidectomy. J Bone Miner Metab 27:240–246CrossRefPubMed
21.
go back to reference Al-Daghri NM, Yakout S, Al-Shehri E, Al-Fawaz HA, Aljohani N, Al-Saleh Y (2014) Inflammatory and bone turnover markers in relation to PTH and vitamin D status among Saudi postmenopausal women with and without osteoporosis. Int J Clin Exp 7:3528–3535 Al-Daghri NM, Yakout S, Al-Shehri E, Al-Fawaz HA, Aljohani N, Al-Saleh Y (2014) Inflammatory and bone turnover markers in relation to PTH and vitamin D status among Saudi postmenopausal women with and without osteoporosis. Int J Clin Exp 7:3528–3535
22.
go back to reference Garnero P, Munoz F, Sornay-Rendu E, Delmas PD (2007) Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study. Bone 40:716–722CrossRefPubMed Garnero P, Munoz F, Sornay-Rendu E, Delmas PD (2007) Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study. Bone 40:716–722CrossRefPubMed
23.
go back to reference Dawson-Hughes B, Harris SS, Krall EA, Dallal GE, Falconer G, Green CL (1995) Rates of bone loss in postmenopausal women randomly assigned to one of two dosages of vitamin D. Am J Clin Nutr 61:1140–1145PubMed Dawson-Hughes B, Harris SS, Krall EA, Dallal GE, Falconer G, Green CL (1995) Rates of bone loss in postmenopausal women randomly assigned to one of two dosages of vitamin D. Am J Clin Nutr 61:1140–1145PubMed
24.
go back to reference Hunter D, Major P, Arden N, Swaminathan R, Andrew T, MacGregor AJ, Keen R, Snieder H, Spector TD (2000) A randomized controlled trial of vitamin D supplementation on preventing postmenopausal bone loss and modifying bone metabolism using identical twin pairs. J Bone Miner Metab 15:2276–2283CrossRef Hunter D, Major P, Arden N, Swaminathan R, Andrew T, MacGregor AJ, Keen R, Snieder H, Spector TD (2000) A randomized controlled trial of vitamin D supplementation on preventing postmenopausal bone loss and modifying bone metabolism using identical twin pairs. J Bone Miner Metab 15:2276–2283CrossRef
25.
go back to reference Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 80:1052–1058PubMed Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 80:1052–1058PubMed
26.
go back to reference Sahota O, Masud T, San P, Hosking DJ (1999) Vitamin D insufficiency increases bone turnover markers and enhances bone loss at the hip in patients with established vertebral osteoporosis. Clin Endocrinol (Oxf) 51:217–221CrossRef Sahota O, Masud T, San P, Hosking DJ (1999) Vitamin D insufficiency increases bone turnover markers and enhances bone loss at the hip in patients with established vertebral osteoporosis. Clin Endocrinol (Oxf) 51:217–221CrossRef
27.
go back to reference Scharla SH, Scheidt-Nave C, Leidig G, Woitge H, Wuster C, Seibel MJ, Ziegler R (1996) Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: a population-based study. Exp Clin Endocrinol Diabetes 104:289–292CrossRefPubMed Scharla SH, Scheidt-Nave C, Leidig G, Woitge H, Wuster C, Seibel MJ, Ziegler R (1996) Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: a population-based study. Exp Clin Endocrinol Diabetes 104:289–292CrossRefPubMed
28.
go back to reference Kuchuk NO, van Schoor NM, Pluijm SM, Chines A, Lips P (2009) Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 24:693–701CrossRefPubMed Kuchuk NO, van Schoor NM, Pluijm SM, Chines A, Lips P (2009) Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 24:693–701CrossRefPubMed
29.
go back to reference Garnero P, Hausherr E, Chapuy MC, Marcelli C, Grandjean H, Muller C, Cormier C, Breart G, Meunier PJ, Delmas PD (1996) Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Miner Res 11:1531–1538CrossRefPubMed Garnero P, Hausherr E, Chapuy MC, Marcelli C, Grandjean H, Muller C, Cormier C, Breart G, Meunier PJ, Delmas PD (1996) Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Miner Res 11:1531–1538CrossRefPubMed
30.
go back to reference Melton LJ 3rd, Khosla S, Atkinson EJ, O’Fallon WM, Riggs BL (1997) Relationship of bone turnover to bone density and fractures. J Bone Miner Res 12:1083–1091CrossRefPubMed Melton LJ 3rd, Khosla S, Atkinson EJ, O’Fallon WM, Riggs BL (1997) Relationship of bone turnover to bone density and fractures. J Bone Miner Res 12:1083–1091CrossRefPubMed
31.
go back to reference von Muhlen DG, Greendale GA, Garland CF, Wan L, Barrett-Connor E (2005) Vitamin D, parathyroid hormone levels and bone mineral density in community-dwelling older women: the Rancho Bernardo Study. Osteoporos Int 16:1721–1726CrossRef von Muhlen DG, Greendale GA, Garland CF, Wan L, Barrett-Connor E (2005) Vitamin D, parathyroid hormone levels and bone mineral density in community-dwelling older women: the Rancho Bernardo Study. Osteoporos Int 16:1721–1726CrossRef
32.
go back to reference Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jimenez F (2001) Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 16:1408–1415CrossRefPubMed Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jimenez F (2001) Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 16:1408–1415CrossRefPubMed
33.
go back to reference Nakamura K, Tsugawa N, Saito T et al (2008) Vitamin D status, bone mass, and bone metabolism in home-dwelling postmenopausal Japanese women: Yokogoshi Study. Bone 42:271–277CrossRefPubMed Nakamura K, Tsugawa N, Saito T et al (2008) Vitamin D status, bone mass, and bone metabolism in home-dwelling postmenopausal Japanese women: Yokogoshi Study. Bone 42:271–277CrossRefPubMed
34.
go back to reference Arabi A, Baddoura R, El-Rassi R, El-Hajj Fuleihan G (2012) PTH level but not 25 (OH) vitamin D level predicts bone loss rates in the elderly. Osteoporos Int 23:971–980CrossRefPubMed Arabi A, Baddoura R, El-Rassi R, El-Hajj Fuleihan G (2012) PTH level but not 25 (OH) vitamin D level predicts bone loss rates in the elderly. Osteoporos Int 23:971–980CrossRefPubMed
Metadata
Title
The levels of bone turnover markers 25(OH)D and PTH and their relationship with bone mineral density in postmenopausal women in a suburban district in China
Authors
C. Gao
J. Qiao
S. S. Li
W. J. Yu
J. W. He
W. Z. Fu
Z. L. Zhang
Publication date
01-01-2017
Publisher
Springer London
Published in
Osteoporosis International / Issue 1/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3692-6

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