SERUM OSTEOCALCIN AND FRACTURE SUSCEPTIBILITY IN ELDERLY WOMEN

The purpose of this investigation was to evaluate the bone turnover by using bone metabolic markers in relation to previous fracture history and independent of bone mass. Patients and controls were recruited fr om a population-based study of 193 women, all living in the same city and aged 60, 70, and 80 years. The bone mineral content (BMC) was meas ured bilaterally in the distal forearm by single-photon absorptiometry (SPA). At the same time, serum samples were obtained for biochemical analysis. Of the 193 women, we identified 26 with at least one major f racture during the past few years. Each of these 26 women with a certi fied recent previous fracture was individually matched with a woman fr om the same study group of equal BMC and age but without a fracture hi story. In the two groups, the serum samples were analyzed for osteocal cin, C-terminal procollagen peptide (P1CP), alkaline phosphatase, bone -specific alkaline phosphatase, calcium, phosphate, and albumin. The s erum concentration of osteocalcin was 20% lower in the women with a pr evious fracture than in the controls (P = 0.03). The other markers of bone formation gave similar values in the two groups. There was a sign ificant correlation between the osteocalcin and P1CP concentrations (P = 0.001). Our findings indicate that the susceptibility to fractures independent of factors such as age and BMC may be related to a decreas ed bone turnover.