Reference Intervals in Danish Children and Adolescents for Bone Turnover Markers Carboxy-terminal Cross-Linked Telopeptide of Type I Collagen (β-CTX), Pro-collagen Type I N-terminal Propeptide (PINP), Osteocalcin (OC) and bone-specific alkaline phosphatase (bone ALP)

Sarah Seberg Diemar, Louise Lylloff, Maria Sode Rønne, Line Tang Møllehave, Malene Heidemann, Betina Heinsbæk Thuesen, Jesper Johannesen, Anders J Schou, Steffen Husby, Niels Wedderkopp, Christian Mølgaard, Niklas Rye Jørgensen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose: Bone turnover markers (BTM) are gaining ground in clinical practice but to fully use their potential there is a need for establishing valid reference intervals (RI). Consequently, the purpose of the study was to establish general RI as well as suggested clinical RI for carboxy-terminal cross-linked telopeptide of type I collagen (β-CTX), pro-collagen type I N-terminal propeptide (PINP), osteocalcin (OC) and bone-specific alkaline phosphatase (bone ALP) in children and adolescents. Method: BTM were measured on Danish children and adolescents participating in the CHAMPS-study DK. A total of 762 participants were included (8–18 years, 50.4% girls) contributing a total of 1410 study visits. The RI was calculated based on 2-years age spans. Participants with biochemical signs of metabolic bone disease were excluded. Results: The differences in RI between age groups clearly reflect changes in growth with an initial increase in BTM, greatest in boys, and a subsequent decrease most pronounced in girls. β-CTX and PINP are markers most affected by these changes, compared to OC and bone ALP. The suggested clinical 95% RI included participants with vitamin D insufficiency but no biochemical signs of metabolic bone disease which did not markedly alter the RI. Conclusion: RI for β-CTX, PINP, OC and bone ALP varies with age and sex. β-CTX and PINP which reflect bone resorption and formation processes are mostly affected by these changes. We suggest a set of clinically applicable 95% RI for the four BTM to heighten the usefulness and generalizability of the RI.

Original languageEnglish
Article number115879
JournalBone
Volume146
ISSN8756-3282
DOIs
Publication statusPublished - May 2021

Bibliographical note

Funding Information:
The study was funded by a grant from Kirsten and Freddy Johansen's Foundation .

Publisher Copyright:
© 2021 Elsevier Inc.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • Bone turnover markers
  • Carboxy-terminal cross-linked telopeptide of type I collagen
  • Children
  • Osteocalcin
  • Pro-collagen type I N-terminal propeptide
  • Reference interval

Fingerprint

Dive into the research topics of 'Reference Intervals in Danish Children and Adolescents for Bone Turnover Markers Carboxy-terminal Cross-Linked Telopeptide of Type I Collagen (β-CTX), Pro-collagen Type I N-terminal Propeptide (PINP), Osteocalcin (OC) and bone-specific alkaline phosphatase (bone ALP)'. Together they form a unique fingerprint.

Cite this