Serum pyridinoline as a specific marker of collagen breakdown and bone metabolism in hemodialysis patients.
Type I collagen represents more than 90% of bone matrix. Quantitative analysis of collagen cross-link molecules such as pyridinoline (PYD) provides valuable information on bone resorption rate. We have studied 37 hemodialysis patients who underwent a systematic transiliac bone biopsy for histomorphometry study. Eighteen of them had tetracycline double labeling, allowing to determine dynamic, in addition to static bone parameters. Measurement of serum-free PYD was performed using a new competitive enzyme immunoassay. Serum PYD values were compared with those of three other serum markers of bone metabolism, namely intact PTH (iPTH), bone-specific alkaline phosphatase (bAP), and osteocalcin, for the correlations with bone histomorphometric parameters. Serum PYD levels (mean +/- SD) were significantly higher in dialysis patients than in normal individuals, 90.6 +/- 99.6 nM versus 1.9 +/- 0.4 nM, respectively. Patients with high turnover bone disease had significantly higher serum PYD levels than patients with normal or low bone turnover, 108.8 +/- 108.0 nM versus 34.1 +/- 12.8 nM, respectively. Serum PYD levels were positively correlated with bone resorption parameters including osteoclast surface (r = 0.59, p < 0.0001) and osteoclast number/mm2 (r = 0.61, p < 0.0001), and also with bone formation parameters, osteoblast surface (r = 0.43, p < 0.008), double-labeled surface (r = 0.81, p < 0.001), and BFR (r = 0.91, p < 0.0001). The BFR was better correlated with serum PYD levels than with either serum iPTH or osteocalcin concentrations. However, correlation with serum bAP was comparable.(ABSTRACT TRUNCATED AT 250 WORDS)
Ureña
P
P
Departement de Nephrologie, INSERM Unité 90, Hôpital Necker-Enfants Malades, Paris, France.
Ferreira
A
A
Kung
V T
VT
Morieux
C
C
Simon
P
P
Ang
K S
KS
Souberbielle
J C
JC
Segre
G V
GV
Drüeke
T B
TB
De Vernejoul
M C
MC
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000097:blood*; D001862:Bone Resorption / Q000097:blood / Q000175:diagnosis; D001842:Bone and Bones / Q000378:metabolism*; D003094:Collagen / Q000378:metabolism*; D024042:Collagen Type I; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007085:Ilium / Q000473:pathology; D015592:Immunoradiometric Assay; D008297:Male; D008875:Middle Aged; D010006:Osteoblasts / Q000166:cytology / Q000473:pathology; D015675:Osteocalcin / Q000097:blood; D010010:Osteoclasts / Q000166:cytology / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000378:metabolism; D011347:Procollagen / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D014511:Uremia / Q000503:physiopathology / Q000628:therapy
D000596:Amino Acids; D024042:Collagen Type I; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; C015484:pyridinoline; D003094:Collagen; D000469:Alkaline Phosphatase