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Age-related trends and reference intervals of cross-linked C-telopeptide of type I collagen and procollagen type I N-propeptide from a reference population of Sri Lankan adult women

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Abstract

Summary

Refer ence values of bone turnover markers (BTMs) are determined by factors that are country-specific. In Sri Lanka, unavailability of BTM reference data has led to their non-use in management of osteoporosis. The results of this study can be used as reference data for women in Sri Lanka.

Introduction

This study was performed to establish age-related reference intervals for bone resorption marker; cross-linked C-telopeptide of type I collagen (CTX) and bone formation marker; procollagen type I N-propeptide (PINP) in a group of Sri Lankan adult women.

Methods

Adult women (n = 347) aged 20–70 years were recruited using age-stratified random sampling technique and categorized into age groups by decades. Serum CTX and PINP concentration were measured using enzyme-linked immunosorbent assay (ELISA). The geometric mean (95% confidence interval) and 2.5th and 97.5th percentiles were calculated. ANOVA was used to compare the means between groups.

Results

Mean CTX levels were relatively low and remained unchanged between 20 and 49 years. After the age of 49 years, mean CTXconcentration elevated significantly until the age of 70 years (43%, p < 0.001). Mean PINP concentrations were not significantly different between age categories (p > 0.05). Reference intervals of CTX and PINP were based on 2.5th and 97.5th percentile values. Reference intervals of CTX for the age groups of 20–29, 30–39, 40–49, 50–59, and 60–70 years were 0.19–0.97 ng/mL, 0.18–0.95 ng/mL, 0.20–1.29 ng/mL, 0.17–2.20 ng/mL, and 0.17–2.85 ng/mL respectively. Reference intervals of PINP for the same age groups were 118–810 pg/mL, 119–772 pg/mL, 116–645 pg/mL, 108–684 pg/mL, and 108–715 pg/mL respectively.

Conclusion

In Sri Lanka, bone turnover markers are not used in evaluating patients mainly due to lack of normative data. These values can be used as reference data for women in this age group.

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Acknowledgements

We are thankful to the staff of the Nuclear Medicine Unit, Faculty of Medicine (NMU), University of Ruhuna, Galle, Sri Lanka, for the provision of technical and laboratory facilities. Furthermore, we especially acknowledge Mr. Priyanka B. Attanayaka, a technical officer attached to the NMU, for his contribution in performing the ELISA assays. Finally, we thank all the research participants of our study for their cooperation and positive response.

Funding

We received financial support from the University Grants Commission, Sri Lanka (UGC Block Grant Ref no; RU/PG –R/16/02), which was extended to conduct the research.

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Authors and Affiliations

  1. Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Hasanga Rathnayake, Chandima Wickramatilake & Eric De Zoysa

  2. Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Sarath Lekamwasam

  3. Nuclear Medicine Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Eric De Zoysa

  4. Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Janaka Lenora

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  1. Hasanga Rathnayake
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Correspondence to Hasanga Rathnayake.

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Rathnayake, H., Lekamwasam, S., Wickramatilake, C. et al. Age-related trends and reference intervals of cross-linked C-telopeptide of type I collagen and procollagen type I N-propeptide from a reference population of Sri Lankan adult women. Arch Osteoporos 16, 164 (2021). https://doi.org/10.1007/s11657-021-01022-4

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