Observational studyClinical interventions in aging2017
Lower serum P1NP/βCTX ratio and hypoalbuminemia are independently associated with osteoporotic nonvertebral fractures in older adults.
Observational study in Clinical interventions in aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Reference markers of bone turnover for prediction of fracture: a meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- Propionibacterium cheese and bone turnover in active young adults: a randomized-controlled trial.Journal of bone and mineral metabolism · 2026Article
- Changes in Oxidative Stress, Inflammatory and Bone Metabolism Biomarkers Following Sulfurous Water Inhalation in Osteopenic Women.International journal of molecular sciences · 2026Article
- Article
- Jarlsberg cheese consumption is associated with favourable changes in bone turnover markers and BMD in postmenopausal women and older men: a randomised clinical trial.BMJ nutrition, prevention & health · 2026Article
- Assessment of Health-Related Quality of Life and Biomarkers in Long COVID: A 12-Month Longitudinal Feasibility Cohort.Journal of clinical medicine · 2025Article
- The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- The association between the albumin to globulin ratio and thoracic spine bone mineral density in adolescents: NHANES 2011-2016.Frontiers in nutrition · 2025Article
- Advanced lung cancer inflammation index as a diagnostic indicator of bone turnover in osteoporotic fracture patients: a non-linear analysis.Frontiers in endocrinology · 2025Article
- Daily cheese intake positively affects serum osteocalcin levels, vitamin K status and bone turnover markers in elderly men and women.BMJ nutrition, prevention & health · 2025Article
- Abnormally low serum albumin levels are associated with abnormal bone mineral density and osteoporotic fractures: a retrospective studies.BMC musculoskeletal disorders · 2024Article
- Study on Risk Factors of Primary Non-traumatic OVCF in Chinese Elderly and a Novel Prediction Model.Orthopaedic surgery · 2022Article
- Article
- Acute Effects of Strength and Endurance Training on Bone Turnover Markers in Young Adults and Elderly Men.Frontiers in endocrinology · 2022Article
- Article
- Bone Turnover in Azerbaijani Patients with Type 2 Diabetes.Iranian journal of public health · 2020Article
- The Impact of Roux-en-Y Gastric Bypass on Bone Remodeling Expressed by the P1NP/βCTX Ratio: a Single-Center Prospective Cohort Study.Obesity surgery · 2019Observational
- Alterations of Bone Metabolism in Patients with Diabetes Mellitus.International journal of endocrinology · 2019Article
- Hypoalbuminemia differently affects the serum bone turnover markers in hemodialysis patients.International journal of medical sciences · 2019Article
- Serum Albumin and Future Risk of Hip, Humeral, and Wrist Fractures in Caucasian Men: New Findings from a Prospective Cohort Study.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2019Article
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4 authors at 2 institutions in 1 country.
Funding
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Abstract
purposeTo estimate the discriminative value of serum P1NP/βCTX ratio and albumin levels in hospitalized orthogeriatric patients with and without nonvertebral fractures.
methodsIn 1,239 orthogeriatric patients (mean age 78.1±9.52 years, 69.1% women) including 854 (68.9%) with osteoporotic nonvertebral fractures (455 [36.7%] with hip fracture [HF]) and 385 (31.1%) without fractures, markers of bone formation (procollagen type 1 N-terminal propeptide [P1NP], osteocalcin [OC], and bone resorption (beta-C-terminal cross-linking telopeptide of type 1 collagen [βCTX]), indices of mineral metabolism, and parameters of liver and renal functions were assessed; data on clinical and laboratory characteristics were collected prospectively.
resultsBoth lower serum P1NP/βCTX ratio and albumin concentration (as continuous or categorical variables) were independently associated with fracture presence in multivariate logistic regressions. Compared with the highest P1NP/βCTX tertile, the prevalence of HF, after adjustment for multiple covariates, was 3-fold higher in the lowest tertile and 1.5 times higher in the middle tertile; presence of any fracture was 2.3- and 1.6-fold higher, respectively; patients with albumin levels in the lowest tertile had multivariate odds ratio (OR) of 4.6 for HF and 2.8 for any fracture, in the middle tertile the ORs were 2.2 and 1.3, respectively. The P1NP/βCTX <100.0 (median) and hypoalbuminemia (<33 g/L) demonstrated area under the curve values for HF of 0.802 and 0.806, respectively, and for any fractures of 0.711 and 0.706, respectively. When both characteristics were combined, the ORs for HF or any fracture, compared with the nonfractured group, were 7.8 and 3.2, respectively, with an accuracy of 79.6% and 71.6%, respectively.
conclusionsIn orthogeriatric patients, both serum P1NP/βCTX ratio and albumin levels demonstrated an inverse dose-effect relationship with the prevalence of nonvertebral fractures and independently indicated fracture presence with acceptable discriminatory power. Lower P1NP/βCTX (<100) and hypoalbuminemia could be useful simple additive prognostic tools for fracture risk stratification in the elderly.
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