Osteoprotegerin autoantibodies do not predict low bone mineral density in middle-aged women.

Purpose: Autoantibodies against osteoprotegerin (OPG) have been associated with osteoporosis. The aim was to develop an immunoassay for OPG autoantibodies and test their diagnostic usefulness of identifying women general population with low bone mineral density.

Methods: Included were 698 women at mean age 55.1 years (range 50.4-60.6) randomly selected from the general population. Measurement of wrist bone mineral density (g/cm2 ) was performed of the non-dominant wrist by dual-energy X-ray absorptiometry (DXA). A T-score < - 2.5 was defined as having a low bone mineral density. Measurements of OPG autoantibodies were carried by radiobinding assays. Cut-off levels for a positive value were determined from the deviation from normality in the distribution of 398 healthy blood donors representing the 99.7th percentile.

Results: Forty-five of the 698 (6.6%) women were IgG-OPG positive compared with 2 of 398 (0.5%) controls ( p  < 0.0001) and 35 of the 698 (5.0%) women had a T-score < - 2.5. There was no difference in bone mineral density between IgG-OPG positive (median 0.439 (range 0.315-0.547) g/cm2 ) women and IgG-OPG negative (median 0.435 (range 0.176-0.652) g/cm2 ) women ( p  = 0.3956). Furthermore, there was neither a correlation between IgG-OPG levels and bone mineral density (rs  = 0.1896; p  = 0.2068) nor T-score (rs  = 0.1889; p  = 0.2086). Diagnostic sensitivity and specificity of IgG-OPG for low bone mineral density were 5.7% and 92.9%, and positive and negative predictive values were 7.4% and 90.8%, respectively.

Conclusion: Elevated OPG autoantibody levels do not predict low bone mineral density in middle-aged women selected from the general population.