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Change of cross-linked telopeptide of type I collagen (ICTP) and other bone resorption markers in patients with bone fragility fractures

  • Original article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The serum concentration of cross-linked telopeptide of type I collagen (ICTP) has been reported to be a useful marker and for both diagnosis and monitoring of bone metastasis. This study was performed to clarify the changes in various bone turnover markers, including ICTP, after bone fragility fracture.

Methods

Seventy-six bone fragility fracture patients (14 men and 62 postmenopausal women; mean age, 77.0 years) were evaluated for bone resorption markers, including serum ICTP. We measured urinary N-terminal telopeptides of type I collagen (NTX) several times after fracture. Furthermore, serum ICTP, serum NTX, urinary deoxypyridinoline (DPD), and urinary C-telopeptide-cross-linked type I collagen (CTX) were measured at the times of both minimum and maximum urinary NTX.

Results

Urinary NTX was increased significantly from 86.4 ± 57.9 to 214.3 ± 137.2 nmol BCE/mmol Cr following fracture. Serum ICTP showed a similar significant increase from 7.6 ± 4.7 to 10.4 ± 5.5 ng/ml in bone fragility fracture patients. Furthermore, other markers also showed similar increases. The level of increase in urinary NTX (148.0%) was especially high compared with other bone resorption markers. On the other hand, the level of increase in serum ICTP (36.8%) was similar to that in serum NTX (39.8%). Serum ICTP levels were significantly correlated with other bone resorption markers, with an especially strong correlation between serum ICTP and serum NTX (r = 0.647, P < 0.001). The percentage of cases in which ICTP exceeded the cutoff value for suspected bone metastasis in postmenopausal women was 73.6%.

Conclusions

The value of ICTP increases with bone fragility fracture and is correlated with other bone resorption markers, and ICTP obviously exceeded the reference value as compared with other bone resorption markers.

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References

  1. SK Brahme V Cervilla V Vint K Cooper K Kortman D Resnick (1990) ArticleTitleMagnetic resonance appearance of sacral insufficiency fractures Skeletal Radiol 9 489–93

    Google Scholar 

  2. SA Stafford DI Rosenthal MC Gebhardt TJ Brady JA Scott (1986) ArticleTitleMRI in stress fracture AJR Am J Roentgenol 147 553–6 Occurrence Handle1:STN:280:DyaL283pt1Kgsw%3D%3D Occurrence Handle3488657

    CAS  PubMed  Google Scholar 

  3. GS Seo J Aoki O Karakida S Sone K Ishii (1997) ArticleTitleIschiopubic insufficiency fractures: MRI appearances Skeletal Radiol 26 705–10 10.1007/s002560050315 Occurrence Handle10.1007/s002560050315 Occurrence Handle1:STN:280:DyaK1c7hsFWqsQ%3D%3D Occurrence Handle9453103

    Article  CAS  PubMed  Google Scholar 

  4. RL Pentecost RA Murray HH Brindley (1964) ArticleTitleFatigue, insufficiency, and pathologic fractures JAMA 187 1001–4 Occurrence Handle1:STN:280:DyaF2c%2FmtVKitQ%3D%3D Occurrence Handle14102934

    CAS  PubMed  Google Scholar 

  5. S Apone MY Lee DR Eyre (1997) ArticleTitleOsteoclasts generate cross-linked collagen N-telopeptides (NTx) but not free pyridinolines when cultured on human bone Bone (NY) 21 129–36 Occurrence Handle1:CAS:528:DyaK2sXlvV2qt7Y%3D

    CAS  Google Scholar 

  6. DA Hanson MAE Weis AM Bollen SL Maslan FR Singer DR Eyre (1992) ArticleTitleA specific immunoassay for monitoring human bone resorption: quantitation of type I collagen cross-linked N-telopeptides in urine J Bone Miner Res 7 1251–8 Occurrence Handle1:CAS:528:DyaK3sXns1CrtQ%3D%3D Occurrence Handle1466251 Occurrence Handle10.1002/jbmr.5650071119

    Article  CAS  PubMed  Google Scholar 

  7. K Takahara M Kamimura H Nakagawa S Uchiyama (2004) ArticleTitleChanges in biochemical markers of bone in patients with insufficiency fractures J Bone Miner Metab 22 618–25 10.1007/s00774-004-0532-0 Occurrence Handle10.1007/s00774-004-0532-0 Occurrence Handle15490274

    Article  PubMed  Google Scholar 

  8. R Tahtela E Tholix (1996) ArticleTitleSerum concentrations of type I collagen carboxyterminal telopeptide (ICTP) and type I procollagen carboxy-and aminoterminal propeptides (PICP, PINP) as markers of metastatic bone disease in breast cancer Anticancer Res 16 2289–93 Occurrence Handle1:STN:280:DyaK28zhtlOluw%3D%3D Occurrence Handle8694558

    CAS  PubMed  Google Scholar 

  9. KK Miyamoto SA McSherry SP Robins JM Besterman JL Mohler (1994) ArticleTitleCollagen cross-link metabolites in urine as markers of bone metastases in prostatic carcinoma J Urol 151 909–13 Occurrence Handle1:STN:280:DyaK2c7nt1OgtA%3D%3D Occurrence Handle7510346

    CAS  PubMed  Google Scholar 

  10. I Elomaa P Virkkunen L Risteli J Risteli (1992) ArticleTitleSerum concentration of the cross-linked carboxyterminal telopeptide of type I collagen (ICTP) is a useful prognostic indicator in multiple myeloma Br J Cancer 66 337–41 Occurrence Handle1:STN:280:DyaK38zmvVymuw%3D%3D Occurrence Handle1503907

    CAS  PubMed  Google Scholar 

  11. LD Napoli HH Hansen FM Muggia HL Twigg (1973) ArticleTitleThe incidence of osseous involvement in lung cancer, with special reference to the development of osteoblastic changes Radiology 108 17–21 Occurrence Handle1:STN:280:DyaE3s7ovFyitg%3D%3D Occurrence Handle4350792

    CAS  PubMed  Google Scholar 

  12. LM Atley JS Mort M Lalumiere DR Eyre (2000) ArticleTitleProteolysis of human bone collagen by cathepsin K: characterization of the cleavage sites generating the cross-linked N-telopeptide neoepitope Bone (NY) 26 241–7 Occurrence Handle1:CAS:528:DC%2BD3cXhtFals7g%3D

    CAS  Google Scholar 

  13. Y Nishi L Atley DE Eyre JG Edelson A Superti-Furga T Yasuda et al. (1999) ArticleTitleDetermination of bone markers in pycnodysostosis: effects of cathepsin K deficiency on bone matrix degradation J Bone Miner Res 14 1902–8 10.1359/jbmr.1999.14.11.1902 Occurrence Handle10.1359/jbmr.1999.14.11.1902 Occurrence Handle1:CAS:528:DyaK1MXnsFektrc%3D Occurrence Handle10571690

    Article  CAS  PubMed  Google Scholar 

  14. ML Sassi H Eriksen L Risteli S Niemi J Mansell M Gowen et al. (2000) ArticleTitleImmunochemical characterization of assay for carboxyterminal telopeptide of human type I collagen: loss of antigenicity by treatment with cathepsin K Bone (NY) 26 367–73 Occurrence Handle1:CAS:528:DC%2BD3cXhslaksrg%3D

    CAS  Google Scholar 

  15. M Koizumi Y Yamada T Takiguchi E Nomura M Furukawa T Kitahara et al. (1995) ArticleTitleBone metabolic markers in bone metastases J Cancer Res Clin Oncol 121 542–8 10.1007/BF01197767 Occurrence Handle10.1007/BF01197767 Occurrence Handle1:STN:280:DyaK28%2FjsVSjtA%3D%3D Occurrence Handle7559734

    Article  CAS  PubMed  Google Scholar 

  16. A Aruga M Koizumi R Hotta S Takahashi E Ogata (1997) ArticleTitleUsefulness of bone metabolic markers in the diagnosis and follow-up of bone metastasis from lung cancer Br J Cancer 76 760–4 Occurrence Handle1:STN:280:DyaK2svlsVWltQ%3D%3D Occurrence Handle9310242

    CAS  PubMed  Google Scholar 

  17. M Kamimura S Uchiyama K Takahara H Hashidate A Kawaguchi H Nakagawa (2005) ArticleTitleUrinary excretion of type I collagen cross-linked N-telopeptide and serum bone-specific alkaline phosphatase. Age and back pain-related changes in elderly women J Bone Miner Metab 23 495–500 10.1007/s00774-005-0634-3 Occurrence Handle10.1007/s00774-005-0634-3 Occurrence Handle1:CAS:528:DC%2BD2MXhtFKktrzK Occurrence Handle16261458

    Article  CAS  PubMed  Google Scholar 

  18. M Kamimura H Nakagawa K Takahara H Hashidate S Uchiyama (2005) ArticleTitleChange in bone specific turnover markers after femoral neck fractures Osteoporosis Jpn 13 355–60

    Google Scholar 

  19. H Nakagawa M Kamimura K Takahara H Hashidate A Kawaguchi S Uchiyama et al. (2006) ArticleTitleChanges in total alkaline phosphatase level after hip fracture: comparison between femoral neck and trochanter fracture J Orthop Sci 11 135–9 10.1007/s00776-005-0990-9 Occurrence Handle10.1007/s00776-005-0990-9 Occurrence Handle1:CAS:528:DC%2BD28XivFSgs70%3D Occurrence Handle16568384

    Article  CAS  PubMed  Google Scholar 

  20. K Akesson SM Käkönen PO Josefsson MK Karlsson KJ Obrant K Pettersson (2005) ArticleTitleFracture-induced changes in bone turnover: a potential confounder in the use of biochemical markers in osteoporosis J Bone Miner Metab 23 30–5 10.1007/s00774-004-0537-8 Occurrence Handle10.1007/s00774-004-0537-8 Occurrence Handle1:CAS:528:DC%2BD2MXhtVelug%3D%3D Occurrence Handle15616891

    Article  CAS  PubMed  Google Scholar 

  21. OOA Oni JP Mahabir SJ Iqbal PJ Gregg (1989) ArticleTitleSerum osteocalcin and total alkaline phosphatase levels as prognostic indicators in tibial shaft fractures Injury 20 37–8 10.1016/0020-1383(89)90042-9 Occurrence Handle10.1016/0020-1383(89)90042-9 Occurrence Handle1:STN:280:DyaK3c%2FnslKisQ%3D%3D Occurrence Handle2592063

    Article  CAS  PubMed  Google Scholar 

  22. S Joerring LT Jensen GR Andersen JS Johansen (1992) ArticleTitleTypes I and III procollagen extension peptides in serum respond to fracture in humans Arch Orthop Trauma Surg 111 265–7 10.1007/BF00571521 Occurrence Handle10.1007/BF00571521 Occurrence Handle1:STN:280:DyaK3s%2FgtFyrtA%3D%3D Occurrence Handle1389778

    Article  CAS  PubMed  Google Scholar 

  23. S Joerring M Krogsgaard H Wilbek LT Jensen (1994) ArticleTitleCollagen turnover after tibial fractures Arch Orthop Trauma Surg 113 334–6 10.1007/BF00426183 Occurrence Handle10.1007/BF00426183 Occurrence Handle1:STN:280:DyaK2M7jsVKjuw%3D%3D Occurrence Handle7833212

    Article  CAS  PubMed  Google Scholar 

  24. BM Ingle SM Hay HM Bottjer R Eastell (1999) ArticleTitleChanges in bone mass and bone turnover following distal forearm fracture Osteoporos Int 10 399–407 10.1007/s001980050246 Occurrence Handle10.1007/s001980050246 Occurrence Handle1:STN:280:DC%2BD3c7ht1OjsA%3D%3D Occurrence Handle10591838

    Article  CAS  PubMed  Google Scholar 

  25. BM Ingle SM Hay HM Bottjer R Eastell (1999) ArticleTitleChanges in bone mass and bone turnover following ankle fracture Osteoporos Int 10 408–15 10.1007/s001980050247 Occurrence Handle10.1007/s001980050247 Occurrence Handle1:STN:280:DC%2BD3c7ht1OjsQ%3D%3D Occurrence Handle10591839

    Article  CAS  PubMed  Google Scholar 

  26. SA Bowles N Kurdy AM Davis MW France DR Marsh (1996) ArticleTitleSerum osteocalcin, total and bone-specific alkaline phosphatase following isolated tibial shaft fracture Ann Clin Biochem 33 196–200 Occurrence Handle8791981

    PubMed  Google Scholar 

  27. H Mallmin S Ljunghall K Larsson (1993) ArticleTitleBiochemical markers of bone metabolism in patients with fracture of the distal forearm Clin Orthop 295 259–63 Occurrence Handle8403658

    PubMed  Google Scholar 

  28. Y Sato M Kaji F Higuchi I Yanagida K Oishi K Oizumi (2001) ArticleTitleChanges in bone and calcium metabolism following hip fracture in elderly patients Osteoporos Int 12 445–9 10.1007/s001980170088 Occurrence Handle10.1007/s001980170088 Occurrence Handle1:CAS:528:DC%2BD3MXls1KqtLc%3D Occurrence Handle11446559

    Article  CAS  PubMed  Google Scholar 

  29. Y Nishizawa T Nakamura H Ohta K Kushida I Gorai M Shiraki et al. (2005) ArticleTitleGuidelines for the use of biochemical markers of bone turnover in osteoporosis (2004) J Bone Miner Metab 23 97–104 10.1007/s00774-004-0547-6 Occurrence Handle10.1007/s00774-004-0547-6 Occurrence Handle15750686

    Article  PubMed  Google Scholar 

  30. M Koizumi S Takahashi E Ogata (1999) ArticleTitleBone metabolic markers in bone metastasis of breast cancer Int J Clin Oncol 4 331–7 10.1007/s101470050080 Occurrence Handle10.1007/s101470050080

    Article  Google Scholar 

  31. GJR Cook E Hannaford M See SEM Clarke I Fogelman (2002) ArticleTitleThe value of bone scintigraphy in the evaluation of osteoporotic patients with back pain Scand J Rheumatol 31 245–8 10.1080/030097402320318459 Occurrence Handle10.1080/030097402320318459 Occurrence Handle1:STN:280:DC%2BD38nht1Cmsg%3D%3D Occurrence Handle12369658

    Article  CAS  PubMed  Google Scholar 

  32. DR Eyre MA Paz PM Gallop (1984) ArticleTitleCross-linking in collagen and elastin Annu Rev Biochem 53 717–48 10.1146/annurev.bi.53.070184.003441 Occurrence Handle10.1146/annurev.bi.53.070184.003441 Occurrence Handle1:CAS:528:DyaL2cXlt1Cqtbw%3D Occurrence Handle6148038

    Article  CAS  PubMed  Google Scholar 

  33. J Risteli I Elomaa S Niemi A Novamo L Risteli (1993) ArticleTitleRadioimmunoassay for the pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen: a new serum marker of bone collagen degradation Clin Chem 39 635–40 Occurrence Handle1:CAS:528:DyaK3sXisFSqtbs%3D Occurrence Handle8472358

    CAS  PubMed  Google Scholar 

  34. H Koga S Naito S Koto N Sakamoto M Nakashima T Yamasaki et al. (1999) ArticleTitleUse of bone turnover marker, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), in the assessment and monitoring of bone metastasis in prostate cancer Prostate 39 1–7 10.1002/(SICI)1097-0045(19990401)39:1<1::AID-PROS1>3.0.CO;2-X Occurrence Handle10.1002/(SICI)1097-0045(19990401)39:1<1::AID-PROS1>3.0.CO;2-X Occurrence Handle1:STN:280:DyaK1M3js1Cnug%3D%3D Occurrence Handle10221259

    Article  CAS  PubMed  Google Scholar 

  35. LM Dermers L Costa VM Chinchilli L Gaydos E Curley A Lipton (1995) ArticleTitleBiochemical markers of bone turnover in patients with metastatic bone disease Clin Chem 41 1489–94

    Google Scholar 

  36. M Sano K Kushida M Takahashi T Ohishi K Kawana M Okada et al. (1994) ArticleTitleUrinary pyridinoline and deoxypyridinoline in prostate carcinoma patients with bone metastasis Br J Cancer 70 701–3 Occurrence Handle1:STN:280:DyaK2M%2FgtFelsw%3D%3D Occurrence Handle7917922

    CAS  PubMed  Google Scholar 

  37. H Miura I Yamamoto M Takada Y Kigami T Ohta I Yuu et al. (1997) ArticleTitleDiagnostic validity of bone metabolic markers for bone metastasis Endocrine J 44 751–7 Occurrence Handle10.1507/endocrj.44.751 Occurrence Handle1:CAS:528:DyaK1cXlsVSjs7s%3D

    Article  CAS  Google Scholar 

  38. M Izumi Y Nakanishi K Takayama K Kimotsuki K Inoue H Wataya et al. (2001) ArticleTitleDiagnostic value of bone-turnover metabolites in the diagnosis of bone metastases in patients with lung carcinoma Cancer (Phila) 91 1487–93 10.1002/1097-0142(20010415)91:8<1487::AID-CNCR1156>3.0.CO;2-2 Occurrence Handle10.1002/1097-0142(20010415)91:8<1487::AID-CNCR1156>3.0.CO;2-2 Occurrence Handle1:STN:280:DC%2BD3M3mtFCrsw%3D%3D

    Article  CAS  Google Scholar 

  39. H Hashidate M Kamimura H Nakagawa K Takahara S Uchiyama (2006) ArticleTitleChanges in bone specific turnover marker after vertebral compression fracture Osteoporosis Jpn 14 286–90

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Suwa Red Cross Hospital, Suwa, Japan

    Kenji Takahara, Hiroyuki Hashidate, Shigeharu Uchiyama & Hiroyuki Nakagawa

  2. Center of Osteoporosis and Spinal Disorders, Kamimura Orthopaedic Clinic, Nagano, Japan

    Mikio Kamimura

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  1. Kenji Takahara
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  2. Mikio Kamimura
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  3. Hiroyuki Hashidate
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  4. Shigeharu Uchiyama
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  5. Hiroyuki Nakagawa
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Takahara, K., Kamimura, M., Hashidate, H. et al. Change of cross-linked telopeptide of type I collagen (ICTP) and other bone resorption markers in patients with bone fragility fractures. J Orthop Sci 12, 219–226 (2007). https://doi.org/10.1007/s00776-007-1113-6

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  • DOI: https://doi.org/10.1007/s00776-007-1113-6

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