Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Body Weight Predicts Bone Density Better Than Resorption Markers

Richard B. Mazess, PhD
Arch Intern Med. 1998;158(3):298-300. doi:.
Text Size: A A A
Published online


Schneider and Barrett-Connor1 found that elevated urinary levels of cross-linked N-telopeptides of type I collagen (NTX) were associated with reduced bone mineral density (BMD) of the spine and proximal femur in older men and women. The authors concluded that NTX levels could "predict" BMD. Osteoporosis experts have come to a quite different conclusion, ie, that urinary markers of resorption cannot predict individual levels of BMD, however useful these markers may be for group data. The authors went wrong by examining only stratification of groups, not the correlation between NTX levels and BMD. The latter correlation is about −0.1 to −0.2 in normal subjects older than 50 years; ie, less than 5% of the variation in BMD was explained by 1 or even several markers.2 Interestingly, Figures 1 and 2 in Schneider and Barrett-Connor's article show that BMD decreased about 10% from the lowest to the highest quintile of NTX. My colleagues and I previously examined the stratification of spine BMD associated with body weight in 1248 non–estrogen-treated postmenopausal women aged 50 to 79 years3 and found a greater difference (15%) between the highest and lowest quintiles.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Bone mineral density (BMD) of the femur neck and total femur in white postmenopausal women (N=567) divided by quintile.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence Summary and Review 2