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

Abstract

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.

Parathyroid Hormone and Bone Marker Levels in Patients with Morbid Obesity Before and After Biliopancreatic Diversion

“…32,33 This can be attenuated by calcium/ vitamin D supplements. 34 The DPD/cre [35][36][37] and the CTx 38,39 have been proposed as markers for bone resorption in weight loss. The higher response of DPD/cre can bear a relation to smaller bone specificity, in turn related to a decrease in urinary creatinine due to the muscle loss.…”

Utility of Biochemical Markers of Bone Turnover and Bone Mineral Density in Management of Osteoporosis

“…91 An automated CTX assay, the Beta-CrossLaps/serum assay on the Roche Elecsys (Roche Diagnostics, Mannheim, Germany) is now available. 92 While standards for the original serum CTX-ELISA were made from antigens immunopurified from human urine; the automated assay utilizes synthetic antigens. 70 Serum and urinary CTX values are highly correlated (r > 0.8), suggesting that the antigen is similar in both types of specimens.…”

Chronic Increase of Bone Turnover Markers After Biliopancreatic Diversion is Related to Secondary Hyperparathyroidism and Weight Loss. Relation with Bone Mineral Density

“…These fragments are released into the circulation after the degradation of several mature collagen molecules of the bone matrix. Therefore, plasma β-CTx levels reflect the degree of bone resorption, and it has been shown that serum β-CTx could be the most useful marker for monitoring the change in bone resorption state in patients with postmenopausal osteoporosis, as well as to accurately assess the therapeutic effect of estrogen replacement therapy by predicting the future rate of BMD change [17,18].…”