Urinary hydroxypyridinium cross-links of collagen in primary hyperparathyroidism.
Urinary concentrations of the collagen cross-links, pyridinoline (PYD) and deoxypyridinoline (DPD), were determined in 87 patients with untreated or surgically treated primary hyperparathyroidism (PHPT). Eighty-four healthy individuals, matched for age and sex, constituted the control group for the excretion of pyridinium cross-links. In addition, a subgroup of 25 patients with PHPT was followed longitudinally for up to 2 yr after successful parathyroidectomy. Mean urinary excretion of PYD (46.8 +/- 2.7 nmol/mmol creatinine) and DPD (17.6 +/- 1.3 nmol/mmol creatinine) was significantly higher in patients with untreated PHPT than in normal subjects (P less than 0.001). In the group undergoing successful parathyroidectomy, mean urinary concentrations of PYD (34 +/- 2.5) and DPD (9.4 +/- 0.8) were similar to those in normal controls and significantly lower than those in the untreated patient population (P less than 0.001). The urinary concentration of both cross-links was significantly correlated with serum levels of both alkaline phosphatase and PTH. Mean urinary concentrations of both cross-link compounds decreased significantly within 6 months in patients followed longitudinally and as early as 2 weeks after surgery in individual patients compared to presurgical baseline values. These changes preceded the reduction in serum alkaline phosphatase and hydroxyproline by approximately 6 months. The results demonstrate that urinary hydroxypyridinium cross-links of collagen are useful indices in the clinical assessment of bone involvement in PHPT.
Seibel
M J
MJ
Department of Orthopedic Surgery, Columbia University College of Physicians and Surgeons, New York, New York 10032.
Gartenberg
F
F
Silverberg
S J
SJ
Ratcliffe
A
A
Robins
S P
SP
Bilezikian
J P
JP
D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D003094:Collagen; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000601:surgery / Q000652:urine*; D008137:Longitudinal Studies; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D012016:Reference Values; D012044:Regression Analysis
D000596:Amino Acids; D015415:Biomarkers; D010281:Parathyroid Hormone; C015484:pyridinoline; C036020:deoxypyridinoline; D003094:Collagen; D000469:Alkaline Phosphatase