Laboratory reproducibility of biochemical markers of bone turnover in clinical practice
To determine the laboratory reproducibility of urine N-telopeptide and serum bone-specific alkaline phosphatase measurements, we sent identical specimens to six US commercial labs over an 8-month period. Longitudinal and within-run laboratory reproducibility varied substantially. Efforts to improve the reproducibility of these tests are needed.
We assessed the laboratory reproducibility of urine N-telopeptide (NTX) and serum bone-specific alkaline phosphatase (BAP).
Serum and urine were collected from five postmenopausal women, pooled, divided into identical aliquots, and frozen. To evaluate longitudinal reproducibility, identical specimens were sent to six US commercial labs on five dates over an 8-month period. To evaluate within-run reproducibility, on the fifth date, each lab was sent five identical specimens. Labs were unaware of the investigation.
Longitudinal coefficients of variation (CVs) ranged from 5.4% to 37.6% for NTX and from 3.1% to 23.6% for BAP. Within-run CVs ranged from 1.5% to 17.2% for NTX. Compared to the Osteomark NTX assay, the Vitros ECi NTX assay had significantly higher longitudinal reproducibility (mean CV 7.2% vs. 30.3%, p < 0.0005) and within-run reproducibility (mean CV 3.5% vs. 12.7%, p < 0.0005).
Reproducibility of urine NTX and serum BAP varies substantially across US labs.
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- Laboratory reproducibility of biochemical markers of bone turnover in clinical practice
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Volume 21, Issue 3 , pp 439-445
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- Bone-specific alkaline phosphatase
- Bone turnover markers
- Laboratory assay
- Urine N-telopeptide
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- Author Affiliations
- 1. Department of Medicine, University of California, San Francisco, CA, USA
- 5. 2200 Post Street, Room C-409, San Francisco, CA, 94115, USA
- 2. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- 3. Department of Pathology, University of California, San Francisco, CA, USA
- 4. Department of Medicine, Kaiser Permanente, Oakland, California, USA