Association of bone turnover markers with mortality in men referred to coronary angiography

Osteoporos Int. 2013 Apr;24(4):1321-32. doi: 10.1007/s00198-012-2076-9. Epub 2012 Jul 10.

Abstract

We aimed to examine the association of fatal events with osteocalcin (OC) and beta-crosslaps (β-CTX) levels in men. We observed a U-shaped association of OC and β-CTX levels with fatal events in a large cohort of men at high cardiovascular risk.

Introduction: Accumulating evidence suggests an association of low OC levels with metabolic disturbances. Whether OC levels are related to fatal events is, however, less clear. Further, high β-CTX levels are linked to increased mortality. We aimed to examine the association of fatal events with both OC and β-CTX in men.

Methods: We measured OC and β-CTX in 2,271 men referred to coronary angiography (1997-2000).

Results: We observed a U-shaped association of OC and β-CTX with fatal events. Crude hazard ratios (HRs) for all-cause and non-cardiovascular mortality in the highest OC quintile were 1.38 (1.04-1.83) and 1.47 (0.89-2.40), respectively, and 2.11 (1.61-2.75) and 2.06 (1.29-3.29) for men in the lowest compared to the third OC quintile. In multivariate-adjusted models, HRs for all-cause, and non-cardiovascular mortality in the lowest OC quintile were 1.63 (1.23-2.16) and 1.79 (1.10-2.92), respectively, compared to the third OC quintile, whereas the association of high OC with mortality lost its significance. Crude and multivariate-adjusted HRs for cardiovascular mortality in the lowest OC quintile compared to the third OC quintile were 2.08 (1.49-2.90) and 1.74 (1.24-2.46), respectively. Moreover, high as well as low β-CTX levels were independently associated with all-cause (quintile 1 vs. quintile 3: HR 1.42 (1.05-1.92); quintile 5 vs. quintile 3: HR 1.79 (1.31-2.45)) and cardiovascular mortality (quintile 1 vs. quintile 3: HR 1.55 (1.05-2.28); quintile 5 vs. quintile 3: HR 1.85 (1.23-2.77)).

Conclusions: We observed a U-shaped association of OC and β-CTX with fatal events in a large cohort of men at high cardiovascular risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Bone Remodeling / physiology*
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / physiopathology
  • Collagen / blood*
  • Coronary Angiography
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Osteocalcin / blood*
  • Peptide Fragments / blood*
  • Prognosis
  • Prospective Studies

Substances

  • Biomarkers
  • Peptide Fragments
  • glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine
  • Osteocalcin
  • Collagen