Bone-related hormones and bone turnover

Bone-related hormones and bone turnover

LASA filenames: LASAC862

Contact: Natasja van Schoor


Throughout life, bone is continuously being turned over by the two processes of bone resorption and bone formation.(1,2) These two processes are usually tightly coupled and result in the replacement of old bone by new bone, which is necessary for the maintenance of the mechanical integrity of the skeleton. Existing bone is resorbed by osteoclasts and new bone is formed by osteoblasts.(3,4). The rate of bone turnover can be assessed by measuring biochemical markers of bone formation and bone resorption in the blood or urine (see for review 5,6). In LASA, serum osteocalcin (OC) and deoxipyridinolin (DPD/Cr) were measured as bone markers. Circulating levels of play an important role in the bone remodeling complex. Therefore, circulating levels of systemic hormones, such as parathyroid hormone (PTH), serum 25-hydroxyvitamin D, sex hormones, and local factors, such as insulin-like growth factor 1 (IGF-1) were also determined in LASA.(7)

Measurements in LASA

Blood collection

Blood samples were obtained from respondents who participated in the second medical interview of LASA (1995/96), were born in 1930 and before (aged 65 years and older as of 1 January, 1996) and were living in Amsterdam, Zwolle and Oss and surroundings. At the visit in the hospital or health care center, fasting urine and blood samples were obtained, centrifuged and stored at -20° or -70° until determination in 1997/1998.

Measurement procedure & variable information

Measurements of the hormone concentrations and markers of bone turnover were carried out at the Endocrine Laboratory of the VU University Medical Center (VUmc). Measurement of hormonal factors and biochemical markers included sex hormone-binding globulin (SHBG), insulin-like growth factor 1 (IGF-1), osteocalcin (OC), deoxypyridinolin (DPD) and creatinine (Cr).
SHBG was measured by means of immuno radiometric assay (Orion Diagnostica, Espoo, Finland, and Incstar Corp., Stillwater, MN, USA, respectively). IGF-1 was determined by immunoradiometricassay after extraction (DSL, Webster, TX, USA). Serum levels of intact OC were measured using a immunoradiometric assay (Biosource Diagnostics, Fleurus, Belgium). Urinary excretions of DPD were measured by competitive immunoassay (ACS 180, Chiron Diagnostics, Emeryville, USA) Values were corrected for creatinine concentration in the same urine sample.
To estimate the coefficient of variation (CV), the measurements were measured twice in a subsample. %CV are available on request at the Endocrine Laboratory of the VUmc.

Availability of data per wave

Table 1.  Number of samples available, the lower limits of quantitation and mean values (SD) for biochemical parameters in blood and fasting urine.

Hormone /bone marker a N Lower limits
SHBG (nmol/l)

IGF-1 (nmol/l)

OC (nmol/l)






6 nM

1 nM

0.1 nM

15 nM

48.4 (22.4)

13.8 (5.2)

2.2 (1.1)

39.2 (29.2)

a SHBG=Sex Hormone Binding Globulin;
IGF-1=insulin-like growth factor-1;


Table 2. Intra- and inter-assay coefficient of variation of OC.

OC intra-assay inter-assay
mean %CV mean %CV
level 1 0,9 5% 0,7 5%
level 2 > 1,7 3% 3,5 8%
level 3


Table 3. Numbers of respondents per wave.

B C 2B* G 3B*
SHBG (nmol/l) 1320
IGF-1 (nmol/l) 1319
OC (nmol/l) 1319
DPD (nmol/l) 1308

* 2B=baseline second cohort;
3B=baseline third cohort

Previous use in LASA

Research of Kuchuk et al. (2007) shows that low levels of bioE2 and bioT were found to be associated with high bone turnover, low QUS and BMD and high risk of osteoporotic fractures in both men and women. Dhonukshe-Rutten et al. (2005) stated that high Hcy and low vitamin B12 concentrations were significantly associated with low BUA, high markers of bone turnover, and increased fracture risk. Pluijm et al. (2002) concluded bone markers and fractures were not associated with lower ApoE epsilon4 in either women or men.


  1. Lips P. Metabolic causes and prevention of hip fractures (PhD-thesis). Vrije Universiteit, Amsterdam, 1982.
  2. Parfitt AM. The coupling of bone formation to bone resorption: a critical analysis of the concept and of its relevance to the pathogenesis of osteoporosis. Metab Bone Dis Relat Res 1982; 4: 1-6.
  3. Dempster DW, Lindsay R. Pathogenesis of osteoporosis. Lancet 1993; 341: 797-801.
  4. Delmas PD and Beaudreuil J. Biochemical markers of bone turnover in osteoporosis. J Clin Rheumatology 1997; 3: 211-216.
  5. Delmas PD, Eastell R, Garnero P, Seibell MJ, Stepan J. The use of biochemical markers of bone turnover in osteoporosis. Osteoporos Int 2000; 11 (Suppl 6): S2-S17.
  6. Pluijm SMF. Predictors and consequences of falls and fractures in the elderly (PhD-thesis). Vrije Universiteit, Amsterdam, 2001.
  7. SMF Pluijm, M Visser, JH Smit, C Popp-Snijders, JC Roos, P Lips. Determinants of bone mineral density in older men and women: body composition as mediator. J Bone Miner Res 2001; 16: 2142-2151.

Date of last update: April 2, 2020