Analytical considerations and plans to standardize or harmonize assays for the reference bone turnover markers PINP and β-CTX in blood

Bhattoa, Harjit Pal; Cavalier, Étienne; Eastell, Richard; Heijboer, Annemieke C.; Jørgensen, Niklas Rye; Makris, Konstantinos; Ulmer, Candice Z.; Kanis, John А.; Cooper, Cyrus; Silverman, Stuart L.; Vasikaran, Samuel

doi:10.1016/j.cca.2020.12.023

Cited by 37 publications

(27 citation statements)

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“…Circulating bone remodeling biomarkers can be used to assess bone metabolic status [ 2 ]. Carboxyl-terminal collagen type I crosslinks (CTX) is an indicator of bone resorption, where osteoclasts breaks down the bone tissue, whereas procollagen type 1 N-terminal propeptide (P1NP) is an indicator of bone formation, where osteoblasts build up the bone tissue [ 3 , 4 ]. Studies have shown a circadian pattern for bone remodeling, with high bone resorption taking place during nighttime and high bone formation taking place during daytime, correlating with the highest CTX concentration in the morning after an overnight fast [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Associations between Postprandial Gut Hormones and Markers of Bone Remodeling

et al. 2021

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Gut-derived hormones have been suggested to play a role in bone homeostasis following food intake, although the associations are highly complex and not fully understood. In a randomized, two-day cross-over study on 14 healthy individuals, we performed postprandial time-course studies to examine the associations of the bone remodeling markers carboxyl-terminal collagen type I crosslinks (CTX) and procollagen type 1 N-terminal propeptide (P1NP) with the gut hormones glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and peptide YY (PYY) using two different meal types—a standardized mixed meal (498 kcal) or a granola bar (260 kcal). Plasma concentrations of total GIP, total GLP-1, total PYY, CTX, and P1NP were measured up to 240 min after meal intake, and the incremental area under the curve (iAUC) for each marker was calculated. The iAUC of CTX and P1NP were used to assess associations with the iAUC of GIP, GLP-1, and PYY in linear mixed effect models adjusted for meal type. CTX was positively associated with GIP and GLP-1, and it was inversely associated with PYY (all p < 0.001). No associations of P1NP with GIP or GLP-1 and PYY were found. In conclusion, the postprandial responses of the gut hormones GIP, GLP-1, and PYY are associated with the bone resorption marker CTX, supporting a link between gut hormones and bone homeostasis following food intake.

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Section: Introductionmentioning

confidence: 99%

Associations between Postprandial Gut Hormones and Markers of Bone Remodeling

et al. 2021

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“…β-CTX is a sensitive indicator of bone resorption. Relevant clinical studies have shown that β-CTX can be used to monitor the timeliness and efficacy of treatment in patients with osteoporosis [24]. This study shows that although zoledronic acid combined with teriparatide in the prevention of recurrent fractures has no significant difference with teriparatide monotherapy group, its improvement in BMD, β-CTX is still better than teriparatide monotherapy group.…”

Section: The Diagnosis Of Opmentioning

confidence: 75%

The Clinical Effect of Zoledronic Acid Combined with Teriparatide in Perverting Recurrent Fracture of Osteoporotic Vertebral Compressive Fractures in the Elderly after Percutaneous Kyphoplasty

Zhao¹,

Yang²,

Zhang³

2021

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Background: Zoledronic acid and teriparatide have been proved to be effective in improving bone metabolism and preventing fractures, but there is no clear clinical report on the efficacy of their combined application. Purpose: To discuss the clinical effect of zoledronic acid combined with teriparatide in perverting recurrent fracture of osteoporotic vertebral compressive fractures (OVCF) in the elderly after percutaneous kyphoplasty (PKP). Method: A randomized clinical trial was conducted at the First Affiliated Hospital of Hebei North University in China from September 2018 and September 2019. A total of 60 patients with OVCF were enrolled in the study (zoledronic acid: 20 cases; teriparatide: 20 cases; zoledronic acid + teriparatide: 20 cases). Observe and compare the changes of bone mineral density (BMD), pro-collagen type I N-terminal propeptide (PINP) and cross-linked C-terminal telopeptide of type I collagen (β-CTX) before surgery, 6 months and 1 year after surgery. At the same time, secondary fracture events and adverse reaction events were recorded during the follow-up period. Results: After normalized treatment, the bone metabolism indexes of PINP and β-CTX were improved and BMD was increased in three groups. Adverse Reactions: There was no statistical significance in the incidence of fever, gastrointestinal reactions and myalgia among the three groups (P > 0.05). The incidence of recurrent fractures in group A was higher than that in group C (P < 0.05), but there was no significant difference between group B and group C (P > 0.05). Conclusion: Zoledronic

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“…In patients with renal insufficiency, bone-specific alkaline phosphatase, intact P1NP or TRAP-5b should be preferred over total P1NP or β-CTX. Due to the lack of standardization of β-CTX assays we recommend that patients should be followed by the same laboratory and that laboratories performing bone turnover measurement mention the method used on their results protocols ( 99 , 100 ). Of note, BTM concentrations increase and may remain elevated up to one year after a fracture.…”

Section: Resultsmentioning

confidence: 99%

Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club

et al. 2022

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Glucocorticoids are effective immunomodulatory drugs used for many inflammatory disorders as well as in transplant recipients. However, both iatrogenic and endogenous glucocorticoid excess are also associated with several side effects including an increased risk of osteoporosis and fractures. Glucocorticoid-induced osteoporosis (GIOP) is a common secondary cause of osteoporosis in adults. Despite availability of clear evidence and international guidelines for the prevention of GIOP, a large treatment gap remains. In this narrative review, the Belgian Bone Club (BBC) updates its 2006 consensus recommendations for the prevention and treatment of GIOP in adults. The pathophysiology of GIOP is multifactorial. The BBC strongly advises non-pharmacological measures including physical exercise, smoking cessation and avoidance of alcohol abuse in all adults at risk for osteoporosis. Glucocorticoids are associated with impaired intestinal calcium absorption; the BBC therefore strongly recommend sufficient calcium intake and avoidance of vitamin D deficiency. We recommend assessment of fracture risk, taking age, sex, menopausal status, prior fractures, glucocorticoid dose, other clinical risk factors and bone mineral density into account. Placebo-controlled randomized controlled trials have demonstrated the efficacy of alendronate, risedronate, zoledronate, denosumab and teriparatide in GIOP. We suggest monitoring by dual-energy X-ray absorptiometry (DXA) and vertebral fracture identification one year after glucocorticoid initiation. The trabecular bone score might be considered during DXA monitoring. Extended femur scans might be considered at the time of DXA imaging in glucocorticoid users on long-term (≥ 3 years) antiresorptive therapy. Bone turnover markers may be considered for monitoring treatment with anti-resorptive or osteoanabolic drugs in GIOP. Although the pathophysiology of solid organ and hematopoietic stem cell transplantation-induced osteoporosis extends beyond GIOP alone, the BBC recommends similar evaluation, prevention, treatment and follow-up principles in these patients. Efforts to close the treatment gap in GIOP and implement available effective fracture prevention strategies into clinical practice in primary, secondary and tertiary care are urgently needed.

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Analytical considerations and plans to standardize or harmonize assays for the reference bone turnover markers PINP and β-CTX in blood

Cited by 37 publications

References 37 publications

Associations between Postprandial Gut Hormones and Markers of Bone Remodeling

Associations between Postprandial Gut Hormones and Markers of Bone Remodeling

The Clinical Effect of Zoledronic Acid Combined with Teriparatide in Perverting Recurrent Fracture of Osteoporotic Vertebral Compressive Fractures in the Elderly after Percutaneous Kyphoplasty

Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club

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