Significance of serum CrossLaps as a predictor of changes in bone mineral density during estrogen replacement therapy; comparison with serum carboxyterminal telopeptide of type I collagen and urinary deoxypyridinoline.
The newly developed Elecsys Beta-CrossLaps/serum assay measures C-terminal telopeptide of type I collagen and has thus been proposed as a reliable serum marker for bone resorption. We investigated its usefulness for monitoring the therapeutic effect of estrogen replacement therapy on bone turnover and bone mineral density (BMD) in patients with postmenopausal osteoporosis. Serum Beta-CTx decreased by 43.2% +/- 9.2% (mean +/- SD), and 55.1% +/- 7.0% at 3 and 6 months, respectively, after initiation of estrogen replacement therapy (ERT), which was significantly greater than the respective value of urinary excretion of deoxypyridinoline (DPD) (27.8% +/- 4.1%, 34.1% +/- 4.9%, respectively) or pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) assay (14.5% +/- 4.1%, 13.1% +/- 5.0%, respectively). The percent reduction in serum Beta-CTx at 1, 3, and 6 months after initiation of ERT was significantly correlated in a negative manner with the percent increase in spinal BMD at 6 months. Further, ROC analysis to determine the significance of the percent change in bone resorption markers after 3 months of ERT in predicting the gain in spine BMD after 6 months suggested that serum Beta-CTx and urinary DPD might provide a more discriminating indicator than serum ICTP. In conclusion, the findings suggest that the Elecsys Beta-CrossLaps/serum assay provides a sensitive, and thus useful, tool for assessing bone resorption state in Japanese patients.
Okabe
Reiko
R
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, 545-8585, Osaka, Japan. inaba-m@med.osaka-cu.ac.jp
Inaba
Masaaki
M
Nakatsuka
Kiyoshi
K
Miki
Takami
T
Naka
Hiroshi
H
Moriguchi
Atushi
A
Nishizawa
Yoshiki
Y
D000596:Amino Acids / Q000652:urine*; D001681:Biological Assay / Q000379:methods*; D015415:Biomarkers; D015519:Bone Density; D001862:Bone Resorption; D003094:Collagen / Q000097:blood*; D024042:Collagen Type I; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood*; D012372:ROC Curve
D000596:Amino Acids; D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; C036020:deoxypyridinoline; D003094:Collagen