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Clinical Chemistry 51: 2312-2317, 2005. First published October 13, 2005; 10.1373/clinchem.2005.051524
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Right arrow Endocrinology and Metabolism
(Clinical Chemistry. 2005;51:2312-2317.)
© 2005 American Association for Clinical Chemistry, Inc.

Endocrinology and Metabolism

Serum Concentrations of Cross-Linked N-Telopeptides of Type I Collagen: New Marker for Bone Resorption in Hemodialysis Patients

Yoshifumi Maeno2, Masaaki Inaba1,a, Senji Okuno2, Tomoyuki Yamakawa2, Eiji Ishimura1 and Yoshiki Nishizawa1

1 Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
2 Shirasagi Hospital, Osaka, Japan.

aAddress correspondence to this author at: Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. Fax 81-6-6645-3808; e-mail inaba-m{at}med.osaka-cu.ac.jp.

Background: Urinary cross-linked N-telopeptide of type I collagen (NTX) is a reliable bone resorption marker in patients with metabolic bone disease. We assessed a clinically available serum NTX assay suitable for anuric patients on hemodialysis (HD).

Methods: Serum concentrations of NTX, C-terminal telopeptide of type I collagen (ß-CTX), pyridinoline (PYD), and deoxypyridinoline (DPD) were determined as bone resorption markers, and those of bone alkaline phosphatase (BAP) and intact osteocalcin (OC) as bone formation markers, in 113 male HD patients (mean age, 59.3 years; mean HD duration, 67.7 months). Each patient’s bone mineral density (BMD) in the distal third of the radius was measured twice, with a 2-year interval between measurements, by dual-energy x-ray absorptiometry.

Results: Serum NTX correlated significantly with ß-CTX, PYD, DPD, BAP, and intact OC. NTX, as well as ß-CTX, PYD, DPD, BAP, and intact OC, correlated significantly with BMD at the time of measurement. NTX, ß-CTX, and DPD correlated significantly with the annual change in BMD during the 2-year period thereafter, in contrast to PYD, BAP, and intact OC. Patients in the highest quartile of serum NTX concentrations showed the fastest rate of bone loss. The sensitivity and specificity for detecting rapid bone loss were 48% and 83%, respectively, for serum NTX.

Conclusion: Serum NTX may provide a clinically relevant serum assay to estimate bone turnover in HD patients.




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RADIOGRAPHIC CORRELATION IN ESRD
STEVE DOAK
Clinical Chemistry Online, 27 Apr 2007 [Full text]

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