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Harmonization of commercial assays for PINP; the way forward



International Federation of Clinical Chemistry and Laboratory Medicine and The International Osteoporosis Foundation Joint Committee on Bone Metabolism believes that the harmonization of PINP assays is an achievable and practical goal.


In order to examine the agreement between current commercial assays, a multi-center study was performed for PINP in serum and plasma.


The automated methods for PINP (Roche Cobas and IDS iSYS) gave similar results. A significant proportional bias was observed between the two automated assays and the Orion radioimmunoassay (RIA) for PINP.


Results from other published studies comparing PINP values among these three assays broadly support our findings. Taken together, these results confirm that harmonized PINP measurements exist between the two automated assays (Roche Cobas and IDS iSYS) when the eGFR is > 30 mL/min/1.73m2, but a significant bias exists between the Orion RIA and the two automated assays.


Therefore, in subjects with normal renal function, PINP results reported by the Roche Cobas and IDS iSYS assays are similar and may be used interchangeably, and similar reference intervals and treatment targets could be applied for the two automated assays. Harmonization between the automated assays and the RIA is potentially possible with the use of common calibrators and the development of a reference method for PINP. This should also help ensure that any new commercial assay developed in the future will attain similar results. IOF and IFCC are committed to working together towards this goal with the cooperation of the reagent manufacturing industry.

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RE receives consultancy funding from IDS, Roche Diagnostics, GSK Nutrition, FNIH, Mereo, Lilly, Sandoz, Nittobo, Abbvie, Samsung, Haoma Medica, CL Bio, and Viking and grant funding from Nittobo, IDS, Roche. Amgen, and Alexion. NRJ he has received free reagents for research use from Roche Diagnostics and IDS. JAK reports grant support from Amgen, Lilly, and Radius Health. CC has received lecture fees and honoraria from Amgen, Danone, Eli Lilly, GSK, Kyowa Kirin, Medtronic, Merck, Nestlé, Novartis, Pfizer, Roche, Servier, Shire, Takeda, and UCB outside of the submitted work. SS is a consultant for Radius, Lilly/Pfizer, speaker for Radius, Amgen, and on the advisory boards of Radius, Amgen. EC is a consultant for Diasorin and IDS.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention, the Public Health Service, and the US Department of Health and Human Services.

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Correspondence to S. D. Vasikaran.

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Vasikaran, S., Bhattoa, H., Eastell, R. et al. Harmonization of commercial assays for PINP; the way forward. Osteoporos Int 31, 409–412 (2020).

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  • Bone resorption
  • Bone turnover markers
  • Harmonization
  • PINP
  • Procollagen type I N-propeptide