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Reference intervals for bone turnover markers in Spanish premenopausal women

  • Núria Guañabens EMAIL logo , Xavier Filella , Ana Monegal , Carmen Gómez-Vaquero , María Bonet , Dolors Buquet , Enrique Casado , Dacia Cerdá , Alba Erra , Silvia Martinez , Núria Montalá , Concepción Pitarch , Eduardo Kanterewicz , Miquel Sala , Xavier Surís , Ferran Torres and on behalf of the LabOscat Study Group
Published/Copyright: June 18, 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 2

Abstract

Background: The aims of this study were to establish robust reference intervals and to investigate the factors influencing bone turnover markers (BTMs) in healthy premenopausal Spanish women.

Methods: A total of 184 women (35–45 years) from 13 centers in Catalonia were analyzed. Blood and second void urine samples were collected between 8 a.m. and 10 a.m. after an overnight fast. Serum procollagen type I amino-terminal propeptide (PINP) and serum cross-linked C-terminal telopeptide of type I collagen (CTX-I) were measured by two automated assays (Roche and IDS), bone alkaline phosphatase (bone ALP) by ELISA, osteocalcin (OC) by IRMA and urinary NTX-I by ELISA. PTH and 25-hydroxyvitamin D (25OHD) levels were measured. All participants completed a questionnaire on lifestyle factors.

Results: Reference intervals were: PINP: 22.7–63.1 and 21.8–65.5 μg/L, bone ALP: 6.0–13.6 μg/L, OC: 8.0–23.0 μg/L, CTX-I: 137–484 and 109–544 ng/L and NTX-I: 19.6–68.9 nM/mM. Oral contraceptive pills (OCPs) influenced PINP (p=0.007), and low body mass index (BMI) was associated with higher BTMs except for bone ALP. Women under 40 had higher median values of most BTMs. CTX-I was influenced by calcium intake (p=0.010) and PTH (p=0.007). 25OHD levels did not influence BTMs. Concordance between the two automated assays for PINP and particularly CTX-I was poor.

Conclusions: Robust reference intervals for BTMs in a Southern European country are provided. The effects of OCPs and BMI on their levels are significant, whilst serum 25OHD levels did not influence BTMs. Age, calcium intake, BMI and PTH influenced CTX-I. The two automated assays for measuring PINP and CTX-I are not interchangeable.

Keywords: bone turnover markers; osteoporosis
Corresponding author: Núria Guañabens, Service of Rheumatology, Hospital Clínic, IDIBAPS, CIBERehd, University of Barcelona, C/Villarroel 170, 08036 Barcelona, Spain, Phone: +34 93 2275400 ext 2236, E-mail:

Acknowledgments

This study was funded by a research grant from the Catalan Society of Rheumatology. The kits were generously provided by Roche Diagnostics and by Immunodiagnostic Systems, Spain.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

LabOscat Study group

Marta Larrosa, Rheumatology Department, University Institute Parc Taulí, Sabadell; Joan Miquel Nolla, Rheumatology Department, IDIBELL, Hospital Universitari de Bellvitge, L’Hospitalet, Barcelona; Pilar Peris, Rheumatology Department, Hospital Clinic, IDIBAPS, CIBERehd, Barcelona; Daniel Roig-Vilaseca, Rheumatology Department, Hospital Moisés Broggi, Barcelona.

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Received: 2015-2-16
Accepted: 2015-5-18
Published Online: 2015-6-18
Published in Print: 2016-2-1

©2016 by De Gruyter

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https://doi.org/10.1515/cclm-2015-0162
Keywords for this article
bone turnover markers; osteoporosis

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Total error vs. measurement uncertainty: the match continues
  4. Review
  5. Application of fatty acid and lipid measurements in neuropsychiatry
  6. Mini Review
  7. The Janus faces of acquired angioedema: C1-inhibitor deficiency, lymphoproliferation and autoimmunity
  8. Opinion Papers
  9. How to report results of prothrombin and activated partial thromboplastin times
  10. Useful measures and models for analytical quality management in medical laboratories
  11. Total error vs. measurement uncertainty: revolution or evolution?
  12. Genetics and Molecular Diagnostics
  13. Rapid detection of Mmalton α1-antitrypsin deficiency allele by real-time PCR and melting curves in whole blood, serum and dried blood spot samples
  14. General Clinical Chemistry and Laboratory Medicine
  15. Diagnostic and clinical significance of Crohn’s disease-specific pancreatic anti-GP2 and anti-CUZD1 antibodies
  16. Immunoassays for the detection of IgA antibodies to tissue transglutaminase: significance of multiples of the upper limit of normal and inter-assay correlations
  17. Effects of biobanking conditions on six antibiotic substances in human serum assessed by a novel evaluation protocol
  18. Haematology and Coagulation
  19. Measurement of dabigatran, rivaroxaban and apixaban in samples of plasma, serum and urine, under real life conditions. An international study
  20. Reference Values and Biological Variations
  21. Upper reference limits for cerebrospinal fluid total protein and albumin quotient based on a large cohort of control patients: implications for increased clinical specificity
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  23. Cancer Diagnostics
  24. Citrulline as a biomarker of gastrointestinal toxicity in patients with rectal carcinoma treated with chemoradiation
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  26. Cardiovascular Diseases
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  28. Cardiac troponin I release after a basketball match in elite, amateur and junior players
  29. The role of timely measurement of galectin-3, NT-proBNP, cystatin C and hsTnT in predicting prognosis and heart function after heart transplantation
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  32. A comparison of three commercial platforms for urinary NGAL in critically ill adults
  33. Diabetes
  34. Liquid citrate acidification introduces significant glucose bias and leads to misclassification of patients with diabetes
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