European Journal of Nuclear Medicine

, Volume 13, Issue 1, pp 32–35

Whole body retention of 99mTc-diphosphonate. Relation to biochemical indices of bone turnover and to total body calcium

  • Karsten Thomsen
  • Julia Johansen
  • Lisbeth Nilas
  • Claus Christiansen


Whole body retention (WBR) and urinary excretion (UE) of 99mTc-diphosphonate were determined in 161 healthy adults and the results were compared to accepted biochemical markers of bone turnover. WBR was corrected for total body bone mineral (TBBM) and UE for forearm bone mineral content (BMC). Both uncorrected and corrected retention measurements were highly significantly correlated to the biochemical markers (P<0.001), but the r values were low (0.22–0.64). All bone turnover variables demonstrated considerably higher levels of bone turnover in postmenopausal women than in premenopausal women (P<0.001), whereas the variables were unchanged with age in men. The correction of WBR for TBBM and UE for BMC increased the validity of the retention methods and the two calculations gave exactly the same results on a group basis, both demonstrating significantly higher bone turnover in women than in men in each age group (P<0.05−P<0.001). All the turnover variables were measured in a group of perimenopausal women (n=33). The data clearly demonstrated that bone turnover is menopause dependent, whereas age in itself is of minor significance.

Key words

Bone turnover Whole body retention Postmenopausal women 


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  1. Caniggia A, Vattimo A (1980) Kinetics of 99m-technetiumtin methylene-diphosphonate in normal subjects and pathological condition: a simple index of bone metabolism. Calcif Tissue Int 30:5–13Google Scholar
  2. Christiansen C, Rødbro P (1977) Long-term reproducibility of bone mineral content measurements. Scand J Clin Lab Invest 37:321–323Google Scholar
  3. Christiansen C, Rødbro P, Jensen H (1975) Bone mineral content in the forearm measured by photon absorptiometry. Principles and reliability. Scand J Clin Lab Invest 35:323–330Google Scholar
  4. Delmas PD, Wahner HW, Mann KG, Riggs BL (1983) Assessment of bone turnover in postmenopausal osteoporosis by measurement of serum bone Gla-protein. J Lab Clin Med 102:470–475Google Scholar
  5. Documenta Geigy (1970) Mathematics and statistics. Ciba-Geigy, Basle, p 180Google Scholar
  6. Fogelman I (1980) Skeletal uptake of diphosphonate: a review. Eur J Nucl Med 5:473–476Google Scholar
  7. Fogelman I, Bessent RG (1982) Age-related alterations in skeletal metabolism — 24-h whole-body retention of diphosphonate in 250 normal subjects: concise communication. J Nucl Med 23:296–300Google Scholar
  8. Fogelman I, Bessent RG, Cohen HN, Hart DM, Lindsay R (1980) Skeletal uptake of diphosphonate. Method for prediction of post-menopausal osteoporosis. Lancet II:667–670Google Scholar
  9. Fogelman I, Bessent RG, Scullion JE, Cuthbert GF (1982) Accuracy of 24 h whole-body (skeletal) retention of diphosphonate measurements. Eur J Nucl Med 7:359–363Google Scholar
  10. Fogelman I, Bessent RG, Turner JG, Citrin DL, Boyle IT, Greig WR (1978) The use of whole-body retention of Tc-99m diphosphonates in the diagnosis of metabolic bone disease. J Nucl Med 19:270–275Google Scholar
  11. Gotfredsen A, Borg J, Christiansen C, Mazess RB (1984a) Total body bone mineral in vivo by dual photon absorptiometry. I. Measurement procedures. Clin Physiol 4:343–355Google Scholar
  12. Gotfredsen A, Borg J, Christiansen C, Mazess RB (1984b) Total body bone mineral in vivo by dual photon absorptiometry. II. Accuracy. Clin Physiol 4:357–362Google Scholar
  13. Hagerup L, Eriksen M, Schroll M, Hollnagel H, Agner E, Larsen S (eds) The Glostrup population studies collection of epidemiologic tables. (Reference values for use in cardiovascular population studies)Google Scholar
  14. Heaney RP, Recker RR, Saville PD (1978) Menopausal changes in calcium balance performance. J Lab Clin Med 92:953–963Google Scholar
  15. Hyldstrup L, McNair P, Jensen GF, Mogensen NB, Transbøl I (1984a) Measurements of whole body retention of diphosphonate and other indices of bone metabolism in 125 normals: dependency on age, sex and glomerular filtration. Scand J Clin Lab Invest 44:673–678Google Scholar
  16. Hyldstrup L, Mogensen N, Jensen GF, McNair P, Transbøl I (1984b) Urinary 99m-Tc-diphosphonate excretion as a simple method to quantify bone metabolism. Scand J Clin Lab Invest 44:105–109Google Scholar
  17. Johansen JS, Mølholm Hansen JE, Christiansen C (1987) A radioimmunoassay for bone Gla protein (BGP) in human plasma. Acta Endocrinol 114:410–416Google Scholar
  18. Meunier PJ, Sellami S, Briancon D, Edouard C (1980) Histological heterogeneity of apparently idiopathic osteoporosis. In: De-Luca HF, Frost HM, Jee WSS, Johnston CC Jr, Parfitt AM (eds) Osteoporosis: Recent advances in pathogenesis and treatment. Baltimore, University Park Press, pp 293–301Google Scholar
  19. Nilas L, Nørgaard H, Pødenphant J, Gotfredsen A, Christiansen C (1987) Bone composition in the distal forearm. Scand J Clin Invest 47:41–46Google Scholar
  20. Parfitt AM, Kleerekoper M (1984) Diagnostic value of bone histomorphometry and comparison of histologic measurements and biochemical indices of bone remodeling. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Proceedings of the Copenhagen international symposium on osteoporosis, Copenhagen, pp 111–120Google Scholar
  21. Parfitt AM, Mathews CME, Villaneuva AR, Rao DS, Rogers M, Kleerekoper M, Frame B (1983) Microstructural and cellular basis of age related bone loss and osteoporosis. In: Frame B, Potts JT Jr (eds) Clinical disorders of bone and mineral metabolism. Excerpta Medical, Amsterdam, pp 328–332Google Scholar
  22. Price PA, Nishimoto SK (1980) Radioimmunoassay for the vitamin K-dependent protein of bone and its discovery in plasma. Proc Natl Acad Sci USA 77:2234–2238Google Scholar
  23. Pødenphant J, Larsen N-E, Christiansen C (1984) An easy and reliable method for determination of urinary hydroxyproline. Clin Chem Acta 142:145–148Google Scholar
  24. Riis BJ, Thomsen K, Christiansen C (1986) Does 24R,25(OH)2 vitamin D3 prevent postmenopausal bone loss? Calcif Tissue Int 38:318–322Google Scholar
  25. The committee of enzymes of the Scandinavian Society for Clinical Physiology (1974) Recommended methos for determination of four enzymes in the blood. Scand J Clin Invest 33:291–306Google Scholar
  26. Thomsen K, Gotfredsen A, Christiansen C (1986a) Bone turnover in healthy adults measured by whole body retention and urinary excretion to 99mTc-MDP. Normalization by skeletal mass. Scand J Clin Lab Invest 46:587–592Google Scholar
  27. Thomsen K, Nilas L, Mogensen T, Christiansen C (1986b) Determination of bone turnover by urinary excretion of 99mTc-MDP. Eur J Nucl Med 12:342–345Google Scholar
  28. Whyte MP, Bergfeld MA, Murphy WA, Avioli LV, Teitelbaum SL (1982) Postmenopausal osteoporosis: a heterogeneous disorder as assessed by histomorphometric analysis of iliac crest bone from untreated patients. Am J Med 72:193–202Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • Karsten Thomsen
    • 1
  • Julia Johansen
    • 1
  • Lisbeth Nilas
    • 1
  • Claus Christiansen
    • 1
  1. 1.Department of Clinical ChemistryUniversity of Copenhagen, Glostrup HospitalGlostrupDenmark

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