Aging clinical and experimental research · 2025
Osteocalcin and frailty among older women.
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Paulin Tine Kolenda, Malmgren Linnea, Bartosch Patrik, Ivaska Kaisa K, McGuigan Fiona E A, Akesson Kristina E
Аннотация
BACKGROUND: Osteocalcin is a bone-specific protein involving many physiological processes, primarily bone turnover. Also closely related to the musculoskeletal system is the frailty syndrome.
AIM: To investigate if circulating osteocalcin levels and frailty are associated in the old, and in addition, if the presumed association is mediated through alterations in bone.
METHODS: 999 community-dwelling women from the OPRA (Osteoporosis Prospective Risk Assessment) cohort, all aged 75 years. Serum total osteocalcin was measured together with bone turnover markers PINP and CTX. An OPRA-adapted frailty index was applied. Association between osteocalcin and frailty was investigated using both logistic regression (osteocalcin quintiles Qlow-Qhigh; Q1-Q5) and linear regression. Splines model was added. Association between osteocalcin level and individual components of the frailty index were investigated using Kruskal-Wallis or Chi2 test.
RESULTS: Low osteocalcin (Q1) was associated with being frail (frailty prevalence 36% vs. 23% (Q1 vs. Q5); absolute difference 13%) in both unadjusted (ORunadj 1.82, 95% CI[1.12-3.00]) and adjusted analyses (ORadj 2.55, 95% CI[1.46-4.44]); even after adjustment for bone turnover markers, s-PINP and s-CTX (2.50, 95% CI[1.11-5.61]). Women with low serum osteocalcin (Q1) had significantly poorer gait function (gait speed (p = 0.001; p for trend < 0.001), more steps taken (p = 0.003; p for trend 0.004)), higher inflammation (p < 0.001; p for trend < 0.001), and a larger proportion had diabetes (p for trend < 0.001) and polypharmacy (p for trend < 0.001), compared to those with highest osteocalcin levels (Q5).
CONCLUSION: Low osteocalcin in circulation was associated with being frail, also after adjusting for bone turnover markers.
AIM: To investigate if circulating osteocalcin levels and frailty are associated in the old, and in addition, if the presumed association is mediated through alterations in bone.
METHODS: 999 community-dwelling women from the OPRA (Osteoporosis Prospective Risk Assessment) cohort, all aged 75 years. Serum total osteocalcin was measured together with bone turnover markers PINP and CTX. An OPRA-adapted frailty index was applied. Association between osteocalcin and frailty was investigated using both logistic regression (osteocalcin quintiles Qlow-Qhigh; Q1-Q5) and linear regression. Splines model was added. Association between osteocalcin level and individual components of the frailty index were investigated using Kruskal-Wallis or Chi2 test.
RESULTS: Low osteocalcin (Q1) was associated with being frail (frailty prevalence 36% vs. 23% (Q1 vs. Q5); absolute difference 13%) in both unadjusted (ORunadj 1.82, 95% CI[1.12-3.00]) and adjusted analyses (ORadj 2.55, 95% CI[1.46-4.44]); even after adjustment for bone turnover markers, s-PINP and s-CTX (2.50, 95% CI[1.11-5.61]). Women with low serum osteocalcin (Q1) had significantly poorer gait function (gait speed (p = 0.001; p for trend < 0.001), more steps taken (p = 0.003; p for trend 0.004)), higher inflammation (p < 0.001; p for trend < 0.001), and a larger proportion had diabetes (p for trend < 0.001) and polypharmacy (p for trend < 0.001), compared to those with highest osteocalcin levels (Q5).
CONCLUSION: Low osteocalcin in circulation was associated with being frail, also after adjusting for bone turnover markers.