Utilization and Reference Values of Bone Turnover Markers: Osteocalcin and Procollagen Type 1 N-Propeptide

Background The use of bone turnover markers in clinical practice and research in younger people is limited by the lack of normative data and understanding of common causes of variation in bone turnover marker values in this demographic. To appropriately interpret bone turnover markers, robust reference intervals specific to age, development and sex are necessary. This study aimed to determine reference intervals of bone turnover markers in females aged 16–25 years participating in the Safe-D study. Methods Participants were recruited through social networking site Facebook and were asked to complete an extensive, online questionnaire and attend a site visit. Participants were tested for serum carboxy-terminal cross-linking telopeptide of type 1 collagen and total procollagen type 1 N-propeptide using the Roche Elecsys automated analyser. Reference intervals were determined using the 2.5th to 97.5th percentiles of normalized bone turnover marker values. Results Of 406 participants, 149 were excluded due to medical conditions or medication use (except hormonal contraception) which may affect bone metabolism. In the remaining 257 participants, the reference interval was 230–1000 ng/L for serum carboxy-terminal cross-linking telopeptide of type 1 collagen and 27–131 µg/L for procollagen type 1 N-propeptide. Both marker concentrations were inversely correlated with age and oral contraceptive pill use. Therefore, intervals specific to these variables were calculated. Conclusions We defined robust reference intervals for cross-linking telopeptide of type 1 collagen and procollagen type 1 N-propeptide in young females grouped by age and contraceptive pill use. We examined bone turnover markers’ relationship with several lifestyle, clinical and demographic factors. Our normative intervals should aid interpretation of bone turnover markers in young females particularly in those aged 16 to 19 years where reference intervals are currently provisional.

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Study of bone turnover markers, procollagen type 1 N-terminal propeptide and osteocalcin in healthy and type 2 diabetes mellitus postmenopausal women

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203041 ◽

2020 ◽

Vol 8 (8) ◽

pp. 2839

Author(s):

G. G. Kaushik ◽

Rajesh Chahar ◽

Subhash Chandra

Keyword(s):

Diabetes Mellitus ◽

Bone Turnover ◽

Postmenopausal Women ◽

Bone Turnover Markers ◽

Diabetic Group ◽

Procollagen Type ◽

Turnover Markers ◽

Type 2 Diabetic

Background: Individuals with diabetes mellitus are at increased risk of metabolic bone disease due to decrease in bone strength and quality. Several bone turnover markers like serum procollagen type I N propeptide (P1NP) and serum osteocalcin are powerful tools for studying osteoporosis and fracture risk across population to provide diagnostic and prognostic information of bone health. The aim of this study was to recognize possible correlation of levels of serum P1NP and osteocalcin in type-2 diabetic (T2DM) postmenopausal women as compared to healthy postmenopausal women.Methods: The study included 100 proven cases of type-2 diabetic postmenopausal women with age matched healthy postmenopausal women as controls. P1NP, osteocalcin, and other relevant parameters were measured. Differences between diabetics and controls were analyzed.Results: The body mass index was higher in diabetic group as compared to controls. The HbA1c% was (6.94±1.43) in diabetic group and (5.57±1.21) in non-diabetics. Low serum level of 25 (OH) D was observed both in diabetic and non-diabetic groups but significantly lower in T2DM. Procollagen type 1 N propeptide was lower in diabetic group (37.59±17.20 ng/mL) as compared to non-diabetic (52.14±24.82 ng/mL). Osteocalcin was lower (15.64±8.06 ng/ml) as compared to non-diabetic group (21.85±9.12 ng/ml). Lower osteocalcin and P1NP levels found in this study suggests slower bone metabolism with reduced bone formation in postmenopausal diabetics.Conclusions: Serum procollagen type 1 N propeptide and osteocalcin in postmenopausal diabetic women were lower as compared to non-diabetic group.

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Relationship between bone turnover markers and oxidative stress in children with type 1 diabetes mellitus

Pediatric Research ◽

10.1038/s41390-020-01197-5 ◽

2020 ◽

Author(s):

Doaa El Amrousy ◽

Dalia El-Afify ◽

Ahmed Shabana

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Bone Turnover ◽

Type 1 Diabetes Mellitus ◽

Bone Turnover Markers ◽

Turnover Markers ◽

And Oxidative Stress

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Effect of vitamin D fortified foods on bone markers and muscle strength in women of Pakistani and Danish origin living in Denmark: a randomised controlled trial

Nutrition Journal ◽

10.1186/s12937-019-0504-9 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Ida M. Grønborg ◽

Inge Tetens ◽

Elisabeth Wreford Andersen ◽

Michael Kristensen ◽

Rikke E. K. Larsen ◽

...

Keyword(s):

Vitamin D ◽

Muscle Strength ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Bone Markers ◽

Knee Extension ◽

Fortified Foods ◽

Knee Extension Strength ◽

Turnover Markers

Abstract Background Deficient and insufficient vitamin D status (defined as serum 25(OH)D < 30 nmol/L and > 50 nmol/L) is prevalent worldwide and associated with decreased muscle strength and poor bone health. We aimed to investigate the effect of vitamin D fortification on bone markers and muscle strength among younger adult women at risk of vitamin D deficiency. Methods A 12-week randomised double-blinded placebo-controlled winter intervention trial, providing 30 μg vitamin D3/day through fortified yoghurt, cheese, eggs and crisp-bread or similar placebo products. Participants were 143 women of Danish and Pakistani origin 18–50 years of age, living in Denmark, randomised into four groups stratified by ethnicity. Serum 25-hydroxyvitamin D (25(OH)D) by LC-MS/MS and the secondary endpoints: four specific bone markers (osteocalcin (OC), Bone specific Alkaline Phosphatase (BALP), Procollagen type 1 amino-terminal propeptide (P1NP), C-terminal crosslinked telopeptide of type 1 collagen (CTX)) and three muscle strength measures (handgrip, knee extension strength, chair-standing), were assessed using one-way ANOVA, Tukey HSD and subsequent linear ANCOVA models, adjusted for relevant covariates. Results Significantly increased serum 25(OH)D concentration from 53.3 (17) to 77.8 (14) nmol/L and from 44.5 (21) to 54.7 (18) nmol/L among Danish and Pakistani women in the fortified groups, respectively (P < 0.05). The bone turnover markers OC, BALP, P1NP and CTX did not change significantly. Muscle strength by handgrip, knee extension and chair-standing test did not change significantly following the intervention. Conclusions Consumption of vitamin D fortified foods for 12 weeks did not result in significant changes of the bone turnover markers OC, BALP, P1NP and CTX. Muscle strength measured as hand grip strength, knee extension strength and chair-standing did not change significantly following the intervention.

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Associations of Circulating Osteoglycin With Bone Parameters and Metabolic Markers in Patients With Diabetes

Frontiers in Endocrinology ◽

10.3389/fendo.2021.649718 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jakob Kau Starup-Linde ◽

Rikke Viggers ◽

Bente Langdahl ◽

Soeren Gregersen ◽

Simon Lykkeboe ◽

...

Keyword(s):

Bone Turnover ◽

Bone Turnover Markers ◽

Type I Collagen ◽

Microvascular Complications ◽

Whole Body ◽

Type I ◽

Amino Terminal ◽

Patients With Diabetes ◽

Turnover Markers

ObjectiveCirculating osteoglycin may facilitate the crosstalk between bone and pancreas to empower adaptation of bone mass to whole body energy balance. We aimed to examine whether osteoglycin is associated with bone and metabolic parameters and if osteoglycin levels differ between patients with type 1 and 2 diabetes (T1D and T2D).Design and methodsA cross-sectional study of 190 patients with diabetes mellitus and stable hemoglobin A1c (HbA1c) (97 T1D and 93 T2D) was conducted. S-osteoglycin was analyzed by ELISA. Unpaired t-tests were performed to test differences between patients with T1D and T2D and linear regression analyses were performed to investigate associations between osteoglycin, glycemic markers, bone turnover markers and characteristics.ResultsS-osteoglycin did not differ between patients with T1D and T2D (p=0.10). No associations were present between osteoglycin and age, gender, microvascular complications, HbA1c, or plasma glucose in T1D or T2D patients (p>0.05 for all). S-osteoglycin was not associated with levels of bone turnover markers (C-terminal cross-linked telopeptide of type-I collagen (CTX), P-procollagen type 1 amino terminal propeptide (P1NP), P-osteocalcin (OC), P-sclerostin, S-osteoprotegerin (OPG) or S-Receptor Activator of Nuclear factor Kappa beta Ligand (RANKL)) in neither T1D or T2D patients (p>0.05 for all).ConclusionOsteoglycin levels were similar in T1D and T2D patients. Osteoglycin did not correlate with glucose, HbA1c or any other biochemical marker of bone turnover. Thus, we did not find evidence supporting the existence of an osteoglycin-bone-pancreas axis.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT01870557.

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THU0262 LEVELS OF OSTEOCALCIN AND PROCOLLAGEN TYPE I C-TERMINAL PROPEPTIDE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS, THEIR ASSOCIATION WITH BONE MINERAL DENSITY AND LEVEL OF INTERLEUKIN-6

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2604 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 358.2-358

Author(s):

S. Shevchuk ◽

L. Denyshchych

Keyword(s):

Bone Turnover ◽

Bone Tissue ◽

Lupus Erythematosus ◽

Bone Turnover Markers ◽

Type I ◽

Z Score ◽

Tissue Metabolism ◽

Procollagen Type ◽

Procollagen Type I ◽

Turnover Markers

Background:Osteoporosis and fractures associated with it are considered to be one of the most severe complications of systemic lupus erythematosus (SLE). The role of a systemic inflammatory process, vitamin D deficiency, hypogonadism and peculiarities of disease treatment in reduced bone mineral density (BMD) is being discussed. Even though the frequency of osteoporosis in patients with SLE is being studied extensively by scientists from different countries, data on the peculiarities of bone tissue metabolism and the factors that provoke disorders of bone remodeling in such individuals are quite limited. The association between markers of bone tissue metabolism and BMD, and how they change during an inflammatory process is poorly studied.Objectives:The objective of our research is to study the levels of osteocalcin (OC) and procollagen type I C-terminal propeptide (PICP) in patients with systemic lupus erythematosus and to estimate their association with BMD and inflammatory activity based on the levels of interleukin-6 (IL-6).Methods:A total of 58 women with SLE (the average age was 45.11 ± 1.03 years old) and 29 individuals from the control group (the average age was 46.79 ± 2.30 years old) were examined. The diagnosis of SLE was established on the basis of 2019 EULAR/ACR classification criteria for SLE. Levels of IL-6, OC and PICP in serum were determined by enzyme immunoassay. Changes in BMD of the lumbar spine at the level of L1-L4 and the proximal femur were determined by dual-energy X-ray absorptiometry. In postmenopausal women, the diagnosis of osteoporosis was established by the T-score ≤ -2.5 SD. Osteopenia met T-score from -1 to -2.5 SD. In women of reproductive age, the Z-score was used to determine BMD. Values of the Z-score ≤ -2.0 SD were considered as “below expected range for age”.Results:The average OC level in serum of practically healthy individuals equaled 17.64 ± 0,59 ng/ml, and in patients with SLE it was 13.96 ± 0.40 ng/ml, i.e. it was 20.9% lower. The average PICP level in the control group equaled 107.8 ± 4.28 ng/ml, in the main group it was 92.9 ± 5.01 ng/ml, i.e. 16% lower. Overall, the decrease in the bone turnover markers (PICP and/or OC) was noticed in 28 patients with SLE (48.3%) and only in 4 practically healthy individuals (13.8%).In women with decreased bone turnover markers, the T-score of the lumbar spine and hip was 2.3-2.6 times lower (p < 0.05) than in the group with adequate levels of bone turnover markers. Z-score was also lower among patients with decreased levels of OC and PICP. In this group, the average BMD level was 0.81 ± 0.05 g/cm2and was 13.8% lower than in the group of patients with no signs of bone tissue metabolism disorder – 0.94 ± 0.02 g/cm2. Among the group of women with signs of suppression of biosynthetic processes in bone tissue, there were twice more individuals with decreased BMD. In patients with critically high levels of IL-6 (above 20.0 ng/L), OC level was lower than in patients with high (12.5-20.0 ng/L) and adequate (< 12.5 ng/L) levels of IL-6 (by 17.3 and 19% respectively). The proportion of individuals with low OC levels increased from 31.2% in the last group to 70.6% among patients with critically high levels of IL-6.PICP level was also lower (38.1% and 39.7% respectively) in case of critically high IL-6 levels compared to its high and adequate levels. The proportion of individuals with low PICP levels increased from 6.3% in the group with adequate IL-6 level to 58.8% in the group with critically high IL-6 level.Conclusion:Women with SLE have bone tissue metabolism disorder in the form of decreased bone turnover markers (procollagen type I C-terminal propeptide and osteocalcin) associated with the inflammatory activity. In the group of patients with the signs of suppression of biosynthetic processes in the bone tissue, there were more individuals with decreased BMD.Disclosure of Interests:Sergii Shevchuk Grant/research support from: Celltrion, Inc, Liudmyla Denyshchych: None declared

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