{"doi":"10.1210/clinem/dgae842","title":"Estimating Net Bone Formation Relative to Resorption Using Reference Bone Turnover Markers","abstract":"CONTEXT: Individually, bone resorption or formation markers do not reflect bone balance. OBJECTIVE: (1) Combine reference bone resorption [collagen type I C-telopeptide (CTX)] and formation [procollagen type I propeptide (PINP)] markers to estimate balance by creating a bone balance index (BBI); (2) examine associations of BBI, CTX, or PINP with bone mineral density (BMD) change. DESIGN: Mixed effects linear regression quantified associations of BBI, CTX, or PINP with BMD change rate. SETTING: Community-based cohort (Study of Women's Health Across the Nation). PARTICIPANTS: 535 women transitioning through menopause. MAIN OUTCOME MEASURES: Annualized percent change in lumbar spine (LS) and femoral neck (FN) BMD. RESULTS: In mixed effects linear regression, adjusted for age, body mass index, race/ethnicity, menopause transition stage, and study site, more negative BBI (less favorable balance) related to more BMD loss. Each SD decrement in BBI was associated with a 0.26% greater decline in LS BMD annually and 0.42% greater decline in FN BMD annually (each P < .0001). In separate models, accounting for the previous covariates, greater CTX or PINP predicted more bone loss. Per SD increment in log2CTX, annual BMD decline was 0.37% greater (P < .0001) and 0.47% greater (P < .0001) at the LS and FN, respectively. Per SD increment in log2PINP, annual BMD loss was 0.22% (P < .0001, LS) and 0.19% (P = .01, FN) greater. CONCLUSION: When combined as a BBI, CTX and PINP estimate bone balance; more negative BBI predicts faster BMD loss. Separately, CTX or PINP reflect overall amount of bone turnover; greater CTX or PINP are related to more bone loss.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2024,"id":458950,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9576,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":284567,"name":"Arun S. Karlamangla","orcid":"0000-0003-2293-6064","position":1,"is_corresponding":false},{"id":490182,"name":"Fatma Gossiel","orcid":"0000-0002-1433-2001","position":2,"is_corresponding":false},{"id":315519,"name":"Richard Eastell","orcid":"0000-0002-0323-3366","position":3,"is_corresponding":false},{"id":284569,"name":"Sherri‐Ann M. Burnett‐Bowie","orcid":"0000-0002-0064-096X","position":4,"is_corresponding":false},{"id":284575,"name":"Gail A. Greendale","orcid":"0000-0003-1054-1081","position":5,"is_corresponding":false},{"id":656436,"name":"Albert Shieh","orcid":"0000-0002-0695-7976","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-19T02:03:50.608887Z","pmid":"39657000","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}