Rapid bone microarchitecture decline in older men with high bone turnover—the prospective STRAMBO study
Authors' conclusion
Thus, in the older men followed prospectively for 8 yr, the rate of decline in bone microarchitecture and estimated bone strength was 50%-215% greater in men with high bone turnover (highest quartile, CTX-I above the median) compared to the men with low bone turnover (lowest quartile, CTX-I below the median).
Study context
- Population
- Older men aged 60–87 yr (STRAMBO); bone microarchitecture and strength of distal radius and distal tibia by high-resolution pQCT at baseline, 4 and 8 yr37 on bone-active medications
- Participants
- 825 men
- Exposure
- Highest vs lowest quartile of baseline bone turnover markers (BTMs)
- Outcome
- Distal radius failure load decline by CTX-I quartile
Methodological details8-yr follow-up, adjusted for age and BMI
- 8-yr follow-up
- Adjusted for age and BMI
Main finding
As reported in the abstract
Highest quartile
−0.94
% yr-1
Lowest quartile
−0.31
% yr-1
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| OC quartiles, Tb.BMD | P < 0.001 |
- Osteocalcin (OC) quartiles, Tb.BMD: rate of decrease in Tb.BMD differed between extreme OC quartiles at each skeletal site
tDPD quartiles, distal tibia
- Bone decline (Tt.BMD, Ct.Thd, Ct.Ar, Ct.BMD, failure load) faster in highest vs lowest tDPD quartile
Bone alkaline phosphatase (BAP) quartiles
- Highest BAP quartile had faster loss of Tt.BMD, Tb.BMD, reaction force and failure load vs lowest quartile
PINP
- Link between PINP and bone decline was poor
BTM score quartiles
- Highest score quartile had faster loss of cortical bone and bone strength vs lowest quartile
Original publication
Rapid bone microarchitecture decline in older men with high bone turnover—the prospective STRAMBO study. J Bone Miner Res. Published 4 January 2024. doi:10.
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