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Determinants of Bone Turnover Markers in Healthy Premenopausal Women

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Abstract

Bone turnover markers (BTMs) are widely used for the management of osteoporosis, and the premenopausal reference range is the target value for the treatment of postmenopausal osteoporosis with antiresorbing agents. Three serum BTMs (serum C-telopeptide of type I collagen [CTX], osteocalcin [OC], and N-terminal propeptide of type I procollagen [P1NP]), serum calcium, creatinine, phosphate, magnesium, and follicle-stimulating hormone (FSH) were measured in 638 healthy premenopausal women aged 20–50 years. In 83 women on the contraceptive pill (CP), the levels of the three BTMs adjusted for all confounding factors were 14–26% lower (P < 0.005) than in non-CP users. In 18 women considered perimenopausal for serum FSH levels >30 IU/mL despite having regular menses, BTM levels were significantly higher than in age-matched women. This group of subjects and the women on the CP were excluded from further analysis. The three BTMs significantly decreased with advancing age and were negatively and independently correlated with body mass index (P < 0.001) and serum phosphate. In conclusion, we confirm that CP use is associated with significantly lower BTM values. An increase in BTM concentrations can be observed in perimenopausal women, i.e., women with normal menses but FSH levels >30 IU/mL. BTMs decrease substantially with advancing age, and this appears to be associated with changes in body weight and serum phosphate. New normative ranges for serum OC, CTX, and P1NP were identified; and our findings in general impose a redefinition of the criteria for establishing the normal ranges for BTMs.

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Authors and Affiliations

  1. Rheumatology Unit, University of Verona, Ospedale di Valeggio, 37067, Valeggio, Verona, Italy

    Silvano Adami & Maurizio Rossini

  2. Rheumatology Unit, Azienda Sanitaria 3, Genova, Italy

    Gerolamo Bianchi

  3. Endocrine Unit, University of Florence, Florence, Italy

    Maria Luisa Brandi

  4. Internal Medicine, University of Padua, Padua, Italy

    Sandro Giannini

  5. Ospedale Auxologico, Milan, Unità Operativa di Reumatologia e Malattie del Metabolismo Osseo, Istituto Auxologico Italiano Irccs, Milan, Italy

    Sergio Ortolani

  6. Rhematology Unit, University of Pisa, Pisa, Italy

    Ombretta DiMunno

  7. Rhematology Unit, University of Siena, Siena, Italy

    Bruno Frediani

Authors
  1. Silvano Adami
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  2. Gerolamo Bianchi
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  3. Maria Luisa Brandi
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  4. Sandro Giannini
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  5. Sergio Ortolani
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  6. Ombretta DiMunno
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  7. Bruno Frediani
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  8. Maurizio Rossini
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On behalf of the BONTURNO study group

Corresponding author

Correspondence to Silvano Adami.

Appendix: Study Contributors and Location (in Alphabetical Order)

Appendix: Study Contributors and Location (in Alphabetical Order)

Maurizio Bevilacqua (Milano), Gerolamo Bianchi (Genova), Ottavio Bosello (Verona), Francesco Cantatore (Foggia), Ombretta Di Munno (Pisa), Erio Fiore (Catania), Bruno Frediani (Siena), Nicola Frisina (Catania), Giorgio Gandolini (Milano), Sandro Giannini (Padova), Vincenzo Lo Cascio (Verona), Giovanni Luisetto (Padova), Claudio Marcocci (Pisa), Salvatore Minisola (Roma), Maurizio Muratore (Lecce), Ranuccio Nuti (Siena), Sergio Ortolani (Milano), Gian Battista Rini (Palermo), Maurizio Rossini (Verona), Fabio Massimo Ulivieri (Milano).

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Adami, S., Bianchi, G., Brandi, M.L. et al. Determinants of Bone Turnover Markers in Healthy Premenopausal Women. Calcif Tissue Int 82, 341–347 (2008). https://doi.org/10.1007/s00223-008-9126-5

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  • DOI: https://doi.org/10.1007/s00223-008-9126-5

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