Gender Differences in Serum Markers of Bone Resorption in Healthy Subjects and Patients with Disorders Affecting Bone

Abstract

To assess how two different serum markers of bone resorption may reflect changes in bone turnover, we compared age- and sex-related changes in serum C-terminal telopeptide of type I collagen (betaCTx) and tartrate-resistant acid phosphatase activity (TRAP) in 136 healthy men and 184 normal women. Serum levels of the two markers were also assessed in several groups of patients of both sexes presenting with the most common metabolic and endocrine bone diseases: established osteoporosis (n = 77), primary hyperparathyroidism (n = 44), glucocorticoid excess (n = 17), chronic renal failure (n = 39), active Paget's disease of bone (n = 5), humoral hypercalcemia of malignancy (n = 3), osteomalacia (n = 3), hyperthyroidism (n = 10), post-surgical hypoparathyroidism (n = 10), acromegaly (active disease, n = 8) and Cushing's syndrome (n = 10). In men the regression of betaCTx with age showed an initial decrease in bone resorption followed by an increase thereafter, starting from the sixth decade of life. No age-related change in serum TRAP activity was observed. In women, by contrast, a slight but significant linear correlation of both serum betaCTx and TRAP with age (r = 0.223, p<0.003 and r = 0.333, p<0.0001, respectively) was found, the two markers being positively correlated (r = 0.238, p<0.002). In each class of patients the mean Z-scores of betaCTx were significantly higher than those of TRAP activity. Moreover, compared with normal subjects, serum betaCTx seems to be characterized by a superior sensitivity relative to TRAP measurement, at least in the disorders studied.

Thyroid hormone independent associations between serum TSH levels and indicators of bone turnover in cured patients with differentiated thyroid carcinoma.

“…Second morning void urine was measured for excretion of N-telopeptide of collagen cross-links (NTx). We choose not to measure cathepsin K or TRAP levels for various reasons, including age and gender differences (28,29). Furthermore, CTx seems to reflect bone resorption better than TRAP, especially during hyperthyroidism (29).…”

“…We choose not to measure cathepsin K or TRAP levels for various reasons, including age and gender differences (28,29). Furthermore, CTx seems to reflect bone resorption better than TRAP, especially during hyperthyroidism (29). Plasma, serum, and urine samples were handled immediately and stored at K80 8C in Sarstedt tubes.…”

Hypoparathyroidism: disease update and new methods of treatment

“…Дефицит ПТГ способствует снижению скорости костного ремоделирования [25], что подтверждается при исследовании мар-керов костного обмена в крови (снижаются) и биопсии подвздошной кости [26]. При про-ведении двухэнергетической рентгеновской абсорбциометрии (DEXA) наблюдается уве-личение минеральной плотности костной ткани (МПК), особенно в участках с преобла-…”

Bones and Groans: The Basics of Osteoporosis and the Use of Bone Markers

“…Men reach their lowest bone-marker concentrations between 50 and 60 years of age after which concentrations may increase slightly. 42,43 Since bone formation and resorption are so closely related, markers often behave similarly; that is, a trend observed with a marker of formation is seen with a marker of resorption. Since each originates from, or is involved in, a specific part of bone remodeling, they should not be expected to behave identically.…”

“…For example, bone markers respond much more rapidly if antiresorptive drug therapy is successful with a decline observed in the resorption markers within 1 to 3 months and in the formation markers in ~3 to 6 months. 21,[43][44][45][46][47][48] This is much quicker than the 1 to 2 years of drug therapy required before significant changes are seen in the DXA BMD measurements. 22,48 Other studies suggest that bone marker concentrations measured at the time of menopause are a better indicator of a woman's risk of developing osteoporosis.…”