Preanalytical Variability of Biochemical Markers of Bone Turnover

Hannon, Rosemary A.; Eastell, Richard

doi:10.1007/s001980070004

Cited by 222 publications

(154 citation statements)

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“…Moreover, serum osteocalcin and NTX levels were highly correlated in our subjects, in contrast to the observations of Aukrust in treatment-naive patients [6]. In our sample, the number of ART-naïve subjects was too few to determine whether the high correlation of osteocalcin and NTX is a result of ART, as observed by Aukrust et al [6] or of estrogen deficiency, which is also associated with increases in both osteocalcin and NTX levels [29]. Serum osteocalcin levels also vary with ethnicity, anthropometric measures, season and geographic locale [30].…”

Section: Discussioncontrasting

confidence: 83%

Bone mass and mineral metabolism in HIV+ postmenopausal women

et al. 2005

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The objective of this cross-sectional study was to estimate the prevalence of and risk factors for osteoporosis in HIV+ postmenopausal women. Bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) and biochemical indices of mineral metabolism were measured in 31 Hispanic and African American HIV+ postmenopausal women. BMD was compared with 186 historical controls, matched for age, ethnicity and postmenopausal status. Mean BMD was significantly lower at the lumbar spine and total hip in the HIV+ group, as compared with controls. Prevalence of osteoporosis was higher in the HIV+ group than controls at the lumbar spine (42% vs 23%, p=0.03) and total hip (10% vs 1%, p=0.003). Among HIV+ women, time since menopause and weight were significant predictors of BMD, while duration or class of

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Section: Discussioncontrasting

confidence: 83%

Bone mass and mineral metabolism in HIV+ postmenopausal women

et al. 2005

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“…It is worth noting again, however, that erythrocyte zinc was not associated with the other markers of bone turnover. It is not clear why such inconsistent associations between markers of bone metabolism and indices of zinc nutritive status were evident in the present study, but it may relate to the quite variable nature of some of the biochemical markers of bone turnover, especially urinary Pyr and Dpyr (Hannon & Eastell, 2000), which may have limited our ability to detect relationships with zinc status.…”

Section: Discussioncontrasting

confidence: 67%

The relationship between the zinc nutritive status and biochemical markers of bone turnover in older European adults: the ZENITH study

et al. 2005

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Objective: To investigate the relationship between indices of zinc nutritive status and biochemical markers of bone turnover in older adult European subjects. Design: Use of baseline data from a multicentre prospective zinc intervention (ZENITH) study. Setting: Centres in France, Italy and Northern Ireland. Participants: A total of 387 healthy adults, aged 55-87 y. Methods: Zinc intake was assessed by 4-day recall records. Circulating and urinary biochemical zinc status measures were assessed by atomic absorption spectrophometry. Serum bone-specific alkaline phosphatase and osteocalcin were assessed by ELISA and urinary pyridinoline (Pyr) and deoxypyridinoline (Dpyr) by HPLC. Results: Zinc intake was negatively correlated with urinary Pyr and Dpyr (r ¼ À0.298 and À0.304, respectively; Po0.0001), but was not correlated with bone formation markers. There was a tendency for serum zinc to be negatively correlated with urinary Dpyr (r ¼ À0.211; P ¼ 0.080). Erythrocyte zinc was negatively correlated with serum osteocalcin (r ¼ À0.090; Po0.0001). None of the other correlations were significant. After adjustment for confounder (age, gender and research centre) the only significant association that remained was between serum osteocalcin and erythrocyte zinc (b ¼ À0.124; P ¼ 0.011). Conclusions: There was some, albeit inconsistent, evidence of a relationship between zinc nutritive status and bone turnover in the older adult participants of the ZENITH study.

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“…There were fewer responders with NTX by the LSC method, although there were more responders using the RI approach, this was also true when those in below the premenopausal mean for NTX at baseline were excluded from the analysis. Urine NTX is more variable than serum assays, and the measurement of creatinine adds to the 'noise', and increases the LSC [27,33] . The LSC values were calculated using a two tailed approach and were comparable with those of Fink et al for PINP CTX and NTX, and Hannon et al for NTX [20,34] , but some were higher than reported by others [20,21] .…”

Section: Discussionmentioning

confidence: 99%

“…Several women had an increase in bone markers at week 12, however, not all BTM were elevated and most had a subsequent decrease. Poor compliance was identified in one of these women and another had a minor orthopaedic operation which would be expected to increase BTMs, particularly PINP [26,27] .…”

Section: Responder Analysis -Least Significant Changementioning

confidence: 99%

Response of bone turnover markers to three oral bisphosphonate therapies in postmenopausal osteoporosis: the TRIO study

et al. 2015

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Introduction: Biochemical response to bisphosphonate therapy can be assessed using either a decrease in bone turnover marker beyond the least significant change (LSC) or a reduction to within a reference interval (RI). We compared the performance of these target responses and determined whether response was related to the type of bisphosphonate, compliance and baseline bone turnover markers.Methods: Biochemical responses to three oral bisphosphonates were assessed in an open, controlled trial comprising 172 postmenopausal osteoporotic women (age 53-84 years), randomized to alendronate, ibandronate or risedronate, plus calcium and vitamin D supplementation for two years. The LSC for each marker was derived within the study population whereas RIs were obtained from a control group of healthy premenopausal women (age 35-40 years).Results: Over 70% of women achieved a target response for serum CTX and PINP, irrespective of the approach used. The percentage decrease at 12 weeks was greater for women with baseline PINP above the RI -63% (difference 13%, 95%CI 0 to 27.1, P=0.049) and good compliance -67% (difference 15.9%, 95%CI 6.3 to 25.5, P=0.001). Responders had a greater increase in spine bone density compared to non-responders; for example 6.2% vs. 2.3%, (difference 3.9%, 95%CI 1.6 to 6.3, p=0.0011) for PINP LSC. The magnitude of change in bone markers was greater with ibandronate and alendronate than risedronate.Conclusions: Both approaches to response identified similar proportions of women as responders. Nonresponders had smaller increases in BMD and we suggest that biochemical assessment of response is a useful tool for the management of women with postmenopausal osteoporosis.Key words: postmenopausal osteoporosis, bone turnover markers, variability, bisphosphonate Mini Abstract (50 words)We used bone turnover markers to identify women who responded to bisphosphonate treatment for osteoporosis.Response was more likely with alendronate and ibandronate, than risedronate. There was a greater decrease in bone markers if baseline bone turnover markers were higher and if the patient took more than 80% of her medication.

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Preanalytical Variability of Biochemical Markers of Bone Turnover

Cited by 222 publications

References 62 publications

Bone mass and mineral metabolism in HIV+ postmenopausal women

Bone mass and mineral metabolism in HIV+ postmenopausal women

The relationship between the zinc nutritive status and biochemical markers of bone turnover in older European adults: the ZENITH study

Response of bone turnover markers to three oral bisphosphonate therapies in postmenopausal osteoporosis: the TRIO study

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