Association of bone turnover markers with mortality in women referred to coronary angiography: the Ludwigshafen Risk and Cardiovascular Health (LURIC) study

• Published in: Osteoporosis international 2014-02, Vol.25 (2), p.455-465
• Main Authors: Lerchbaum, E., Schwetz, V., Pilz, S., Boehm, B. O., März, W.
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; Bone Remodeling - physiology; Bones; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - mortality; Cardiovascular Diseases - physiopathology; Collagen - blood; Coronary Angiography; Endocrinology; Female; Follow-Up Studies; Germany - epidemiology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Original Article; Orthopedics; Osteocalcin - blood; Peptide Fragments - blood; Prospective Studies; Rheumatology; Risk factors; Womens health
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-013-2411-9

Summary We examined the association of fatal events with beta-crosslaps (β-CTX) and osteocalcin (OC) concentrations in women. We observed an independent association of β-CTX and OC concentrations with fatal events in women at high to intermediate cardiovascular risk. Introduction There is some evidence suggesting an association of β-CTX and OC with fatal events in men and frail elderly subjects. We aimed to examine the association of fatal events with β-CTX and OC in women. Methods We measured β-CTX and OC in 986 women aged 65 (58–72) years referred to coronary angiography. Results Compared to the first β-CTX quartile, the crude hazard ratios (HRs) for all-cause and cardiovascular mortality in the highest β-CTX quartile were 2.50 (1.65–3.81) and 3.28 (1.82–5.91), respectively. In multivariate adjusted models, HRs for all-cause and cardiovascular mortality in the highest β-CTX quartile were 1.72 (1.09–2.70) and 2.31 (1.24–4.32), respectively. The lowest 25-hydroxyvitamin D [25(OH)D] quartile was significantly associated with increased risk of all-cause and cardiovascular mortality in multivariate adjusted models. In those models, the highest β-CTX quartile was associated with an increased risk of all-cause and cardiovascular mortality. For OC concentrations, we found a reverse J-shaped association with noncardiovascular mortality. Using the first quartile as reference, crude and multivariate adjusted HRs for noncardiovascular mortality in the second and third OC quartile were 0.41 (0.19–0.90) [multivariate: 0.40 (0.18–0.88)] and 0.51 (0.25–1.06) [multivariate: 0.43 (0.20–0.94)], respectively. The lowest 25(OH)D quartile was associated with a trend towards increased risk of noncardiovascular mortality in multivariate analysis. In that analysis, OC quartile 2 and 3 were significantly associated with lower risk of noncardiovascular mortality. Conclusions We observed an independent association of high β-CTX with all-cause and cardiovascular mortality and a reverse J-shaped association of OC with noncardiovascular mortality.