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Geographic differences in bone turnover: data from a multinational study in healthy postmenopausal women
F J Cohen1, S Eckert, B H Mitlak
1Lilly Research Laboratories, Indianapolis, Indiana 46285, USA.
Calcified Tissue International
|September 24, 1998
Summary
Bone turnover markers like osteocalcin (OC) and CTX vary significantly by country in postmenopausal women. These geographic differences in bone metabolism may influence osteoporosis fracture rates.
Area of Science:
- Endocrinology
- Bone Metabolism Research
- Clinical Trials
Background:
- Biochemical bone markers (OC, BSAP, CTX) are increasingly used to monitor bone loss and fracture risk.
- Geographic variations in fracture rates are known, but their relationship with bone turnover has not been extensively studied.
Purpose of the Study:
- To investigate geographic variability in bone turnover rates among healthy postmenopausal women.
- To explore potential links between bone marker levels and country-specific fracture rates.
Main Methods:
- A study of 619 postmenopausal women (ages 40-61) across 38 sites in 10 countries.
- Standardized measurement of serum osteocalcin (OC), bone-specific alkaline phosphatase (BSAP), and urine CTX.
- Analysis of bone marker levels using ANOVA, controlling for confounders like age and FSH.
Main Results:
- Significant geographic variations observed in mean levels of OC, BSAP, and CTX.
- Highest bone marker levels were found in American and Canadian subjects; lowest in German and Spanish subjects.
- Observed bone marker ranges (1.6-fold for OC, 1.7-fold for BSAP, 3.1-fold for CTX) suggest clinically relevant differences.
Conclusions:
- Bone marker levels exhibit substantial country-specific variations in this postmenopausal cohort.
- These findings suggest systematic geographic differences in bone metabolism.
- Such differences may be related to observed variations in osteoporotic fracture rates globally.