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Serum bone alkaline phosphatase and calcaneus bone density predict fractures: a prospective study
P D Ross1, B C Kress, R E Parson
1Hawaii Osteoporosis Center, Honolulu, Hawaii, USA.
Summary
Serum bone-specific alkaline phosphatase (bone ALP) and urinary collagen crosslinks (CTx) can help identify postmenopausal women at higher risk for osteoporotic fractures, independent of bone mineral density (BMD).
Area of Science:
- Gerontology
- Orthopedics
- Endocrinology
Background:
- Osteoporotic fractures pose a significant health risk for postmenopausal women.
- Accurate identification of fracture risk is crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive ability of serum bone-specific alkaline phosphatase (bone ALP), urinary collagen crosslinks (CTx), and calcaneus bone mineral density (BMD) for osteoporotic fractures in postmenopausal women.
Main Methods:
- Serum bone ALP, urinary CTx, and calcaneus BMD were measured in 512 postmenopausal women.
- Fracture incidence was tracked over an average of 2.7 years.
- Logistic regression models were used to assess associations with new fractures.
Main Results:
- Women experiencing osteoporotic fractures had significantly higher mean baseline serum bone ALP and urinary CTx.
- Serum bone ALP, urinary CTx, and calcaneus BMD were each significantly associated with new fractures.
- Bone mineral density (BMD) and serum bone ALP were identified as significant independent predictors of fracture.
Conclusions:
- Increased bone turnover, indicated by elevated serum bone ALP and urinary CTx, is significantly associated with an increased risk of osteoporotic fracture in postmenopausal women.
- This association is comparable in magnitude and independent of bone mineral density (BMD).