Beom-Jun Kim1, Seunghee Baek2, Seung Hun Lee3, Seong Hee Ahn1, Hyeon-Mok Kim1, Seon Ha Kim4, Min-Woo Jo5, Sung Jin Bae6, Hong-Kyu Kim6, Jaewon Choe6, Gyung-Min Park7, Young-Hak Kim7, Ghi Su Kim1, Jung-Min Koh1. 1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Seoul, Republic of Korea. 2. Department of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Seoul, Republic of Korea. 3. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Seoul, Republic of Korea. Electronic address: hun0108@amc.seoul.kr. 4. Department of Nursing, College of Medicine, Dankook University, 330-715 Cheonan, Republic of Korea. 5. Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Seoul, Republic of Korea. 6. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Seoul, Republic of Korea. 7. Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Seoul, Republic of Korea.
Abstract
BACKGROUND: Pro-inflammatory cytokines play important roles in bone metabolism and several studies have shown that carcinoembryonic antigen (CEA) may promote inflammation. We investigated the association of serum CEA levels with the risk of osteoporosis and incident fracture. METHODS: We performed a small cross-sectional study with 302 Korean women and a large, longitudinal study with 7192 Korean women in an average 3-year follow-up period. For the cross-sectional study, bone mineral density (BMD) and bone turnover markers (BTMs) were measured. For the longitudinal study, incident fractures in the follow-up period were identified by using the selected International Classification of Diseases, 10th revision (ICD-10) codes and the nationwide claims database of the Health Insurance Review and Assessment Service of Korea. RESULTS: In the cross-sectional study, serum CEA levels correlated negatively with BMD at the lumbar spine (γ=-0.023; P=0.029) and positively with BTMs (γ=0.122 to 0.138, P=0.002 to P<0.001) after adjustment for confounding variables. In the longitudinal study, 254 (3.5%) women developed incident fractures in the follow-up period (2.8±1.3 years). After adjustment for potential confounders, the hazard ratio (HR) per 1 ng/mL increment of the baseline CEA level for the development of incident fracture was 1.22 [95% confidence interval (CI): 1.05-1.42]. The HR was markedly higher in subjects in the highest CEA quartile category compared with those in the lowest CEA quartile category (HR=1.54, 95% CI: 1.04-2.28). CONCLUSION: Therefore, serum CEA may be a biomarker of the risk of incident fracture in postmenopausal Korean women.
BACKGROUND: Pro-inflammatory cytokines play important roles in bone metabolism and several studies have shown that carcinoembryonic antigen (CEA) may promote inflammation. We investigated the association of serum CEA levels with the risk of osteoporosis and incident fracture. METHODS: We performed a small cross-sectional study with 302 Korean women and a large, longitudinal study with 7192 Korean women in an average 3-year follow-up period. For the cross-sectional study, bone mineral density (BMD) and bone turnover markers (BTMs) were measured. For the longitudinal study, incident fractures in the follow-up period were identified by using the selected International Classification of Diseases, 10th revision (ICD-10) codes and the nationwide claims database of the Health Insurance Review and Assessment Service of Korea. RESULTS: In the cross-sectional study, serum CEA levels correlated negatively with BMD at the lumbar spine (γ=-0.023; P=0.029) and positively with BTMs (γ=0.122 to 0.138, P=0.002 to P<0.001) after adjustment for confounding variables. In the longitudinal study, 254 (3.5%) women developed incident fractures in the follow-up period (2.8±1.3 years). After adjustment for potential confounders, the hazard ratio (HR) per 1 ng/mL increment of the baseline CEA level for the development of incident fracture was 1.22 [95% confidence interval (CI): 1.05-1.42]. The HR was markedly higher in subjects in the highest CEA quartile category compared with those in the lowest CEA quartile category (HR=1.54, 95% CI: 1.04-2.28). CONCLUSION: Therefore, serum CEA may be a biomarker of the risk of incident fracture in postmenopausal Korean women.