Smoking and other determinants of bone turnover
Open accessAbstract
The balance between bone resorption and formation may be assessed by measurement of bone turnover markers (BTMs), like carboxyl-terminal cross-linked telopeptide of type 1 collagen (CTX-1) and procollagen type 1 amino-terminal propeptide (P1NP). Smoking has been shown to influence bone turnover and to reduce bone mass density (BMD), the exact mechanism for this is, however, not settled. In this post-hoc study including 406 subjects (mean age 51.9 years), we aimed to study the impact of smoking on bone turnover. Moreover, we wanted to assess the inter-correlation between substances regulating bone metabolism and BTMs, as well as tracking over time. BMD measurements and serum analyses of CTX-1, P1NP, osteoprotegerin (OPG), receptor activator of nuclear factor ĸB ligand (RANKL), Dickkopf-1 (DKK1), sclerostin, tumor necrosis factor-α (TNF-α), and leptin were performed. Repeated serum measurements were made in 195 subjects after four months. Adjustments were made for sex, age, body mass index (BMI), smoking status, insulin resistance, serum calcium, parathyroid hormone, 25-hydroxyvitamin D and creatinine. Smokers had higher levels of DKK1 and OPG, and lower levels of RANKL, as reflected in lower BTMs and BMD compared to non-smokers. There were strong and predominantly positive inter-correlations between BTMs and the other substances, and there was a high degree of tracking with Spearman's rho from 0.72 to 0.92 (P < 0.001) between measurements four months apart. In conclusion, smokers exhibited higher levels of DKK1 and OPG and a lower bone turnover than did non-smokers. The strong inter-correlations between the serum parameters illustrate the coupling between bone resorption and formation and crosstalk between cells.
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Smokers had higher levels of DKK1 and lower levels of bone formation (PINP) when compared to nonsmokers.
“Jorde et al. reported that smokers had higher levels of DKK1 and lower levels of bone formation (PINP) when compared to nonsmokers [39].”
From An Overlooked Bone Metabolic Disorder: Cigarette Smoking-Induced Osteoporosis (2022) · cites this paper as [39]
The parathyroid hormone-vitamin D axis is affected by smoking.
“The parathyroid hormone (PTH)–vitamin D axis, which plays a fundamental role in determining BMD and calcium homeostasis, is also affected by smoking [30].”
From Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic (2021) · cites this paper as [30]
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- Authors
- Jorde, R., Stunes, A. K., Kubiak, J., Grimnes, G., Thorsby, P. M., & Syversen, U.
- Affiliations
- University Hospital of North Norway (NO)
- Norwegian University of Science and Technology (NO)
- UiT The Arctic University of Norway (NO)
- Oslo University Hospital (NO)
- Corresponding author
- Jorde, Rolf
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-11-25
- Volume
- 14
- Issue
- 11
- Pages
- e0225539
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6876776
- OpenAlex
- W2991512785
- Cited by
- 25
- References
- 58
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 2 · 2017: 1
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- North Norway Regional Health Authorities (SFP1277-16)
- Uit The Arctic University of Norway
- the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Keywords
- smoking, bone turnover markers, bone resorption, bone formation, bone mineral density, C-terminal telopeptide of type I collagen, P1NP, osteoprotegerin, RANKL, DKK1, sclerostin, TNF-α, leptin, bone metabolism
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Parathyroid Hormone, Peptide Fragments, Procollagen, Smoking, Vitamin D, Biomarkers, Bone Density, Bone Remodeling, Intercellular Signaling Peptides and Proteins, Osteoprotegerin, RANK Ligand
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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