Serum Concentrations of Undercarboxylated and Total Osteocalcin and Other Bone Turnover Markers as Predictors of All‐Cause Mortality in Older Men
| No. of events | Mortality per 100 person‐years | Hazard ratio (95% confidence interval) and p value | ||||||
| Exposure variable | Unadjusted model | Fully adjusted modelc | ||||||
| Undercarboxylated osteocalcin (ucOC) | ||||||||
| Quartile 1a | 488 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 471 | 5.04 | 0.93 | (0.82, 1.06) | 0.97 | (0.84, 1.12) | ||
| Quartile 3 | 526 | 5.74 | 1.08 | (0.95, 1.22) | 1.03 | (0.89, 1.18) | ||
| Quartile 4 | 543 | 6.79 | 1.28 | (1.13, 1.45) | 1.18 | (1.02, 1.36) | ||
| Per 1 SD increaseb | 1.17 | (1.12, 1.22) | <0.001 | 1.12 | (1.06, 1.18) | <0.001 | ||
| Total osteocalcin (TOC) | ||||||||
| Quartile 1a | 437 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 473 | 5.02 | 0.94 | (0.82, 1.07) | 1.04 | (0.87, 1.16) | ||
| Quartile 3 | 519 | 5.46 | 1.01 | (0.89, 1.15) | 0.99 | (0.86, 1.15) | ||
| Quartile 4 | 600 | 7.02 | 1.32 | (1.17, 1.49) | 1.22 | (1.04, 1.41) | ||
| Per 1 SD increaseb | 1.12 | (1.08, 1.16) | <0.001 | 1.02 | (0.98, 1.07) | 0.315 | ||
| Procollagen type I N‐propeptide (PINP) | ||||||||
| Quartile 1a | 522 | 5.63 | 1.00 | 1.00 | ||||
| Quartile 2 | 524 | 5.34 | 0.95 | (0.84, 1.08) | 0.98 | (0.86, 1.12) | ||
| Quartile 3 | 555 | 5.71 | 1.02 | (0.90, 1.14) | 1.09 | (0.95, 1.24) | ||
| Quartile 4 | 603 | 6.91 | 1.23 | (1.11, 1.40) | 1.22 | (1.07, 1.40) | ||
| Per 1 SD increaseb | 1.07 | (1.03, 1.10) | <0.001 | 1.06 | (1.01, 1.11) | 0.009 | ||
| Collagen type 1 C‐terminal cross‐linked telopeptide (CTX) | ||||||||
| Quartile 1a | 495 | 5.12 | 1.00 | 1.00 | ||||
| Quartile 2 | 544 | 5.70 | 1.11 | (0.98, 1.25) | 1.12 | (0.96, 1.27) | ||
| Quartile 3 | 563 | 5.81 | 1.13 | (1.00, 1.27) | 1.14 | (0.99, 1.31) | ||
| Quartile 4 | 601 | 6.99 | 1.39 | (1.23, 1.56) | 1.30 | (1.12, 1.50) | ||
| Per 1 SD increaseb | 1.15 | (1.11, 1.20) | <0.001 | 1.13 | (1.08, 1.19) | <0.001 | ||
| No. of events | Mortality per 100 person‐years | Hazard ratio (95% confidence interval) and p value | ||||||
| Exposure variable | Unadjusted model | Fully adjusted modelc | ||||||
| Undercarboxylated osteocalcin (ucOC) | ||||||||
| Quartile 1a | 488 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 471 | 5.04 | 0.93 | (0.82, 1.06) | 0.97 | (0.84, 1.12) | ||
| Quartile 3 | 526 | 5.74 | 1.08 | (0.95, 1.22) | 1.03 | (0.89, 1.18) | ||
| Quartile 4 | 543 | 6.79 | 1.28 | (1.13, 1.45) | 1.18 | (1.02, 1.36) | ||
| Per 1 SD increaseb | 1.17 | (1.12, 1.22) | <0.001 | 1.12 | (1.06, 1.18) | <0.001 | ||
| Total osteocalcin (TOC) | ||||||||
| Quartile 1a | 437 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 473 | 5.02 | 0.94 | (0.82, 1.07) | 1.04 | (0.87, 1.16) | ||
| Quartile 3 | 519 | 5.46 | 1.01 | (0.89, 1.15) | 0.99 | (0.86, 1.15) | ||
| Quartile 4 | 600 | 7.02 | 1.32 | (1.17, 1.49) | 1.22 | (1.04, 1.41) | ||
| Per 1 SD increaseb | 1.12 | (1.08, 1.16) | <0.001 | 1.02 | (0.98, 1.07) | 0.315 | ||
| Procollagen type I N‐propeptide (PINP) | ||||||||
| Quartile 1a | 522 | 5.63 | 1.00 | 1.00 | ||||
| Quartile 2 | 524 | 5.34 | 0.95 | (0.84, 1.08) | 0.98 | (0.86, 1.12) | ||
| Quartile 3 | 555 | 5.71 | 1.02 | (0.90, 1.14) | 1.09 | (0.95, 1.24) | ||
| Quartile 4 | 603 | 6.91 | 1.23 | (1.11, 1.40) | 1.22 | (1.07, 1.40) | ||
| Per 1 SD increaseb | 1.07 | (1.03, 1.10) | <0.001 | 1.06 | (1.01, 1.11) | 0.009 | ||
| Collagen type 1 C‐terminal cross‐linked telopeptide (CTX) | ||||||||
| Quartile 1a | 495 | 5.12 | 1.00 | 1.00 | ||||
| Quartile 2 | 544 | 5.70 | 1.11 | (0.98, 1.25) | 1.12 | (0.96, 1.27) | ||
| Quartile 3 | 563 | 5.81 | 1.13 | (1.00, 1.27) | 1.14 | (0.99, 1.31) | ||
| Quartile 4 | 601 | 6.99 | 1.39 | (1.23, 1.56) | 1.30 | (1.12, 1.50) | ||
| Per 1 SD increaseb | 1.15 | (1.11, 1.20) | <0.001 | 1.13 | (1.08, 1.19) | <0.001 | ||
Quartile boundaries for ucOC were Q1/2 8.04 μg/L, Q2/3 10.1 μg/L, Q3/4 12.9 μg/L; for TOC, Q1/2 14.5 μg/L, Q2/3 18.6 μg/L, Q3/4 24.0 μg/L; for PINP, Q1/2 28.1 μg/L, Q2/3 36.8 μg/L, Q3/4 49.3 μg/L, and for CTX, Q1/2 0.20 μg/L, Q2/3 0.28 μg/L, Q3/4 0.39 μg/L.
Quartile 1 is reference category for comparisons of hazard ratio (HR) for other quartiles of bone turnover marker.
Change in HR for 1 standard deviation increase in bone turnover marker.
Variables included in the fully adjusted model were age, educational level, smoking status, alcohol consumption, physical activity, blood pressure (BP)‐lowering medications, lipid‐lowering medications, prevalent diabetes, prevalent cardiovascular disease, body mass index, systolic BP, fasting status at time of blood collection, and concentrations of cholesterol, HDL cholesterol, creatinine, and vitamin D.
Serum Concentrations of Undercarboxylated and Total Osteocalcin and Other Bone Turnover Markers as Predictors of All‐Cause Mortality in Older Men
| No. of events | Mortality per 100 person‐years | Hazard ratio (95% confidence interval) and p value | ||||||
| Exposure variable | Unadjusted model | Fully adjusted modelc | ||||||
| Undercarboxylated osteocalcin (ucOC) | ||||||||
| Quartile 1a | 488 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 471 | 5.04 | 0.93 | (0.82, 1.06) | 0.97 | (0.84, 1.12) | ||
| Quartile 3 | 526 | 5.74 | 1.08 | (0.95, 1.22) | 1.03 | (0.89, 1.18) | ||
| Quartile 4 | 543 | 6.79 | 1.28 | (1.13, 1.45) | 1.18 | (1.02, 1.36) | ||
| Per 1 SD increaseb | 1.17 | (1.12, 1.22) | <0.001 | 1.12 | (1.06, 1.18) | <0.001 | ||
| Total osteocalcin (TOC) | ||||||||
| Quartile 1a | 437 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 473 | 5.02 | 0.94 | (0.82, 1.07) | 1.04 | (0.87, 1.16) | ||
| Quartile 3 | 519 | 5.46 | 1.01 | (0.89, 1.15) | 0.99 | (0.86, 1.15) | ||
| Quartile 4 | 600 | 7.02 | 1.32 | (1.17, 1.49) | 1.22 | (1.04, 1.41) | ||
| Per 1 SD increaseb | 1.12 | (1.08, 1.16) | <0.001 | 1.02 | (0.98, 1.07) | 0.315 | ||
| Procollagen type I N‐propeptide (PINP) | ||||||||
| Quartile 1a | 522 | 5.63 | 1.00 | 1.00 | ||||
| Quartile 2 | 524 | 5.34 | 0.95 | (0.84, 1.08) | 0.98 | (0.86, 1.12) | ||
| Quartile 3 | 555 | 5.71 | 1.02 | (0.90, 1.14) | 1.09 | (0.95, 1.24) | ||
| Quartile 4 | 603 | 6.91 | 1.23 | (1.11, 1.40) | 1.22 | (1.07, 1.40) | ||
| Per 1 SD increaseb | 1.07 | (1.03, 1.10) | <0.001 | 1.06 | (1.01, 1.11) | 0.009 | ||
| Collagen type 1 C‐terminal cross‐linked telopeptide (CTX) | ||||||||
| Quartile 1a | 495 | 5.12 | 1.00 | 1.00 | ||||
| Quartile 2 | 544 | 5.70 | 1.11 | (0.98, 1.25) | 1.12 | (0.96, 1.27) | ||
| Quartile 3 | 563 | 5.81 | 1.13 | (1.00, 1.27) | 1.14 | (0.99, 1.31) | ||
| Quartile 4 | 601 | 6.99 | 1.39 | (1.23, 1.56) | 1.30 | (1.12, 1.50) | ||
| Per 1 SD increaseb | 1.15 | (1.11, 1.20) | <0.001 | 1.13 | (1.08, 1.19) | <0.001 | ||
| No. of events | Mortality per 100 person‐years | Hazard ratio (95% confidence interval) and p value | ||||||
| Exposure variable | Unadjusted model | Fully adjusted modelc | ||||||
| Undercarboxylated osteocalcin (ucOC) | ||||||||
| Quartile 1a | 488 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 471 | 5.04 | 0.93 | (0.82, 1.06) | 0.97 | (0.84, 1.12) | ||
| Quartile 3 | 526 | 5.74 | 1.08 | (0.95, 1.22) | 1.03 | (0.89, 1.18) | ||
| Quartile 4 | 543 | 6.79 | 1.28 | (1.13, 1.45) | 1.18 | (1.02, 1.36) | ||
| Per 1 SD increaseb | 1.17 | (1.12, 1.22) | <0.001 | 1.12 | (1.06, 1.18) | <0.001 | ||
| Total osteocalcin (TOC) | ||||||||
| Quartile 1a | 437 | 5.30 | 1.00 | 1.00 | ||||
| Quartile 2 | 473 | 5.02 | 0.94 | (0.82, 1.07) | 1.04 | (0.87, 1.16) | ||
| Quartile 3 | 519 | 5.46 | 1.01 | (0.89, 1.15) | 0.99 | (0.86, 1.15) | ||
| Quartile 4 | 600 | 7.02 | 1.32 | (1.17, 1.49) | 1.22 | (1.04, 1.41) | ||
| Per 1 SD increaseb | 1.12 | (1.08, 1.16) | <0.001 | 1.02 | (0.98, 1.07) | 0.315 | ||
| Procollagen type I N‐propeptide (PINP) | ||||||||
| Quartile 1a | 522 | 5.63 | 1.00 | 1.00 | ||||
| Quartile 2 | 524 | 5.34 | 0.95 | (0.84, 1.08) | 0.98 | (0.86, 1.12) | ||
| Quartile 3 | 555 | 5.71 | 1.02 | (0.90, 1.14) | 1.09 | (0.95, 1.24) | ||
| Quartile 4 | 603 | 6.91 | 1.23 | (1.11, 1.40) | 1.22 | (1.07, 1.40) | ||
| Per 1 SD increaseb | 1.07 | (1.03, 1.10) | <0.001 | 1.06 | (1.01, 1.11) | 0.009 | ||
| Collagen type 1 C‐terminal cross‐linked telopeptide (CTX) | ||||||||
| Quartile 1a | 495 | 5.12 | 1.00 | 1.00 | ||||
| Quartile 2 | 544 | 5.70 | 1.11 | (0.98, 1.25) | 1.12 | (0.96, 1.27) | ||
| Quartile 3 | 563 | 5.81 | 1.13 | (1.00, 1.27) | 1.14 | (0.99, 1.31) | ||
| Quartile 4 | 601 | 6.99 | 1.39 | (1.23, 1.56) | 1.30 | (1.12, 1.50) | ||
| Per 1 SD increaseb | 1.15 | (1.11, 1.20) | <0.001 | 1.13 | (1.08, 1.19) | <0.001 | ||
Quartile boundaries for ucOC were Q1/2 8.04 μg/L, Q2/3 10.1 μg/L, Q3/4 12.9 μg/L; for TOC, Q1/2 14.5 μg/L, Q2/3 18.6 μg/L, Q3/4 24.0 μg/L; for PINP, Q1/2 28.1 μg/L, Q2/3 36.8 μg/L, Q3/4 49.3 μg/L, and for CTX, Q1/2 0.20 μg/L, Q2/3 0.28 μg/L, Q3/4 0.39 μg/L.
Quartile 1 is reference category for comparisons of hazard ratio (HR) for other quartiles of bone turnover marker.
Change in HR for 1 standard deviation increase in bone turnover marker.
Variables included in the fully adjusted model were age, educational level, smoking status, alcohol consumption, physical activity, blood pressure (BP)‐lowering medications, lipid‐lowering medications, prevalent diabetes, prevalent cardiovascular disease, body mass index, systolic BP, fasting status at time of blood collection, and concentrations of cholesterol, HDL cholesterol, creatinine, and vitamin D.
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