Table 3.
The association between serum bone turnover biomarkers in quartile and the risk of hip fracture, The Singapore Chinese Health Study
| Odds ratio (95% confidence interval) | ||||||
|---|---|---|---|---|---|---|
| Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | p for trend |
Per SDd | |
| Bone ALP (U/L), Median (IQR) | 26.5 (23.0–27.8) | 34.0 (31.7–36.4) | 42.2 (39.8–44.0) | 54.6 (50.5–61.1) | ||
| Cases/Controls | 16/25 | 27/25 | 32/25 | 25/25 | ||
| Model 1a | 1.0 (Referent) | 1.68 (0.75–3.80) | 2.08 (0.89–4.88) | 1.56 (0.66–3.70) | 0.28 | 1.20 (0.89–1.62) |
| Model 2b | 1.0 (Referent) | 2.29 (0.91–5.77) | 2.74 (1.03–7.26) | 2.35 (0.84–6.57) | 0.11 | 1.32 (0.93–1.87) |
| Model 3c | 1.0 (Referent) | 2.32 (0.9–5.94) | 2.93 (1.07–8.01) | 2.41 (0.84–6.95) | 0.10 | 1.40 (0.95–2.07) |
| OC (ng/mL), median (IQR) | 11.3 (10.0–12.5) | 16.2 (15.1–16.8) | 21.1 (18.9–23.0) | 28.9 (26.7–33.3) | ||
| Cases/Controls | 12/25 | 27/25 | 26/25 | 35/25 | ||
| Model 1a | 1.0 (Referent) | 2.10 (0.89–4.97) | 2.32 (0.90–5.97) | 3.22 (1.26–8.22) | 0.02 | 1.32 (0.93–1.87) |
| Model 2b | 1.0 (Referent) | 1.84 (0.72–4.68) | 2.48 (0.88–7) | 3.38 (1.2–9.47) | 0.02 | 1.32 (0.92–1.90) |
| Model 3c | 1.0 (Referent) | 2.86 (0.92–8.90) | 6.29 (1.68–23.52) | 8.23 (2.26–30.03) | 0.001 | 1.55 (1.04–2.31) |
| PINP (µg/L), median (IQR) | 26.8 (23.6–30.9) | 39.8 (37.1–42.7) | 49.3 (46.8–52.7) | 67.9 (59.0–82.6) | ||
| Cases/Controls | 16/25 | 25/25 | 20/26 | 39/24 | ||
| Model 1a | 1.0 (Referent) | 1.89 (0.72–4.97) | 1.52 (0.58–3.95) | 3.39 (1.27–9.07) | 0.03 | 1.35 (0.97–1.88) |
| Model 2b | 1.0 (Referent) | 2.30 (0.80–6.60) | 1.50 (0.50–4.47) | 4.54 (1.49–13.77) | 0.02 | 1.45 (1.02–2.06) |
| Model 3c | 1.0 (Referent) | 2.94 (0.97–8.92) | 2.09 (0.65–6.69) | 6.63 (2.02–21.81) | 0.004 | 1.62 (1.10–2.37) |
| CTX-I (ng/mL), median (IQR) | 0.18 (0.13–0.20) | 0.25 (0.23–0.27) | 0.34 (0.31–0.37) | 0.51 (0.47–0.66) | ||
| Cases/Controls | 13/25 | 21/25 | 33/25 | 33/25 | ||
| Model 1a | 1.0 (Referent) | 1.54 (0.68–3.48) | 2.63 (1.09–6.37) | 2.68 (1.09– 6.57) | 0.02 | 1.43 (1.06–1.94) |
| Model 2b | 1.0 (Referent) | 1.53 (0.60–3.91) | 3.49 (1.26–9.68) | 4.00 (1.43–11.18) | 0.004 | 1.58 (1.14–2.19) |
| Model 3c | 1.0 (Referent) | 1.39 (0.54–3.59) | 3.66 (1.28–10.46) | 4.92 (1.67–14.51) | 0.002 | 1.78 (1.24–2.56) |
| NTX-I (BCE/L), median (IQR) | 9.1(7.9–10.2) | 12.2 (11.60–12.60) | 14.4 (13.80–15.20) | 18.6 (16.90–20.70) | ||
| Cases/Controls | 21/25 | 21/25 | 20/25 | 38/25 | ||
| Model 1a | 1.0 (Referent) | 1.15 (0.49– 2.71) | 1.08 (0.42–2.79) | 1.93 (0.81–4.61) | 0.10 | 1.42 (1.04–1.93) |
| Model 2b | 1.0 (Referent) | 1.33 (0.50–3.52) | 1.14 (0.37–3.45) | 2.62 (0.93–7.35) | 0.04 | 1.53 (1.08–2.16) |
| Model 3c | 1.0 (Referent) | 1.57 (0.56–4.42) | 1.70 (0.50–5.73) | 4.32 (1.39–13.45) | 0.006 | 1.95 (1.29–2.93) |
Model 1: conditional logistic regression model that adjusted for matching factors including age at study enrollment (±3 years), sex, dialect group (Hokkien, Cantonese), date of study enrollment (±2 year), and date of biospecimen collection (±6 months);
Model 2 – further adjusted for BMI (kg/m2, continuous), level of education (no formal education, primary school, secondary school or higher), smoking status (never smokers, ex-smokers, current smokers), physical activity (none, 0.5–3.9 hrs weekly, ≥ 4 hrs weekly), soy isoflavones (mg/1,000 kcal/day in quartile), pyridoxine (mg/1,000 kcal/day in quartile), β-carotene (µg/1,000 kcal/day in quartile;
Model 3 – further adjusted for self-reported history of physician-diagnosed diabetes mellitus (yes, no) at baseline;
per SD increase in biomarker levels.