Change of cross-linked telopeptide of type I collagen (ICTP) and other bone resorption markers in patients with bone fragility fractures.
BACKGROUND
The serum concentration of cross-linked telopeptide of type I collagen (ICTP) has been reported to be a useful marker and for both diagnosis and monitoring of bone metastasis. This study was performed to clarify the changes in various bone turnover markers, including ICTP, after bone fragility fracture.


METHODS
Seventy-six bone fragility fracture patients (14 men and 62 postmenopausal women; mean age, 77.0 years) were evaluated for bone resorption markers, including serum ICTP. We measured urinary N-terminal telopeptides of type I collagen (NTX) several times after fracture. Furthermore, serum ICTP, serum NTX, urinary deoxypyridinoline (DPD), and urinary C-telopeptide-cross-linked type I collagen (CTX) were measured at the times of both minimum and maximum urinary NTX.


RESULTS
Urinary NTX was increased significantly from 86.4 +/- 57.9 to 214.3 +/- 137.2 nmol BCE/mmol Cr following fracture. Serum ICTP showed a similar significant increase from 7.6 +/- 4.7 to 10.4 +/- 5.5 ng/ml in bone fragility fracture patients. Furthermore, other markers also showed similar increases. The level of increase in urinary NTX (148.0%) was especially high compared with other bone resorption markers. On the other hand, the level of increase in serum ICTP (36.8%) was similar to that in serum NTX (39.8%). Serum ICTP levels were significantly correlated with other bone resorption markers, with an especially strong correlation between serum ICTP and serum NTX (r = 0.647, P < 0.001). The percentage of cases in which ICTP exceeded the cutoff value for suspected bone metastasis in postmenopausal women was 73.6%.


CONCLUSIONS
The value of ICTP increases with bone fragility fracture and is correlated with other bone resorption markers, and ICTP obviously exceeded the reference value as compared with other bone resorption markers.
Takahara
Kenji
K
Department of Orthopedic Surgery, Suwa Red Cross Hospital, Suwa, Japan.
Kamimura
Mikio
M
Hashidate
Hiroyuki
H
Uchiyama
Shigeharu
S
Nakagawa
Hiroyuki
H
D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001859:Bone Neoplasms / Q000150:complications / Q000378:metabolism / Q000556:secondary; D001862:Bone Resorption / Q000150:complications* / Q000378:metabolism; D024042:Collagen Type I / Q000652:urine*; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000378:metabolism*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000378:metabolism; D010384:Pelvic Bones / Q000293:injuries*; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000652:urine*; D011347:Procollagen / Q000097:blood*; D011863:Radioimmunoassay; D012720:Severity of Illness Index
D000596:Amino Acids; D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C036020:deoxypyridinoline