Serum C-terminal telopeptide of type I collagen in osteoporotic patients with vertebral and hip fracture

초록

Introduction: Bone quality including bone turnover rate have been identified important. Biochemical marker of bone turnover is useful in diagnosis and monitoring response to treatment. However high within-person variability complicate their use. We investigated whether the bone mineral density and bone turnover marker(serum C-terminal telopeptide;cTx and osteocalcin) were associated with fracture in the the patients with femur fracture and vertebral fracture, and also whether sampling time affect the level of cTx. Methods: From January 2004 to December 2004, we had enrolled prospectively 42 patients who visited the emergency department due to fragility fracture in the elderly. 30 patient diagnosed femur fracture(Fx) and 12, vertebral fracture(Vx). Bone mineral densities (BMD) of the lumbar spine and femur were examined. Total calcium, phosphate, alkaline phosphatase, osteocalcin, s-CTx were measured. The patients of femur fracture were divided into two subgroups according to the presence of vertebral fracture. Results: All BMDs of the patients showed osteoporosis. The CTx level increased in the morning than random sampling, but show correlation(r=0.63, p<0.01). The s-CTx levels were higher than control(p<0.05). The group of Fx with Vx was older than Fx only group, and had lower BMD. There were no significant differences in markers between the subgroups. But the incidence of trochanteric fracture was higher in Fx with Vx than Fx only group. Conclusion: Fx in the elderly was associated with osteoporosis, specially in Fx with Vx. The bone turnover markers and BMD are useful to know the degree of osteoporosis in Fx. so we suggest that they are helpful for planning of treatment and prevention of fragility fracture in the elderly.