Correlation between bone turnover markers with bone density and the risk of fragility fracture in patients with lumbar degeneration / 解放军医学杂志

ABSTRACT

Objective: To investigate the correlation between bone turnover markers (BTMs) with bone mineral density (BMD) and the risk of fragility fracture in patients with lumbar degeneration. Methods: One hundred fifty-eight patients with lumbar degeneration were selected from May 2016 to May 2017 in the General Hospital of Western Theater Command. The lumbar BMD of all patients were measured by dual energy X-ray absorptiometry. The levels in fasting venous blood of procollagen type-1 N-terminal propeptide (PINP), Osteocalcin (OC), bone-specific alkaline phosphatase (BALP), C-terminal crosslinking telopeptides of type I collagen (β-CTX), 25-hydroxy Vitamin D (25-(OH)VitD) and tartrate resistant alkaline phosphatase (TRACP) were analyzed with Roche chemiluminescence. The past fragility fractures were analyzed by inquiring medical history and X-ray examination. The correlation between BTMs with BMD and fragility fracture risk were evaluated by multiple logistic regression and linear regression analysis. Results: The incidence of fragility fractures in 158 patients with lumbar degeneration was 20.3%. The BMD was significantly lower in patients with fragility fracture than in patients with no fragility fracture (P<0.05). The levels of PINP, BALP, OC and β-CTX were significantly higher in patients with fragility fracture than in those with no fragility fracture (P<0.05). PINP, BALP, OC, β-CTX and TRACP were negatively correlated with lumbar BMD (β=-0.431, -0.234, -0.167, -0.314 and -0.198, respectively; P=0.021, 0.009, 0.034, 0.033 and 0.049, respectively), and β-CTX and PINP were positively correlated with the fragility fracture risk (P<0.05). Conclusion: PINP, BALP, OC, β-CTX and TRACP were negatively correlated with BMD, and β-CTX and PINP were positively correlated with fragility fracture risk in patients with lumbar degeneration, implying that early monitoring BTMs and early anti-osteoporosis treatment may reduce the risk of long-term screw loosening and fragility fracture in patients with lumbar degeneration after surgery.