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The usefulness of high pre-operative levels of serum type I collagen bone markers for the prediction of changes in bone mineral density after parathyroidectomy

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Abstract

Background: Amino-terminal procollagen propeptide of type I collagen (P1 NP) and cross-linked C-terminal telopeptide of type I collagen (βCTX) are two of the more sensitive bone markers for reflecting and monitoring patients with an increased bone turnover as observed in primary hyperparathyroidism (PHPT) patients. Aim: The present study was performed to evaluate the trend of type I collagen markers one year after parathyroidectomy (PTX) and to examine the relationships between serum P1 NP and βCTX levels and bone mineral density (BMD) change after PTX in PHPT Spanish patients. Materials and methods: Fifty-three PHPT patients were enroled and were followed for one year by measuring lumbar BMD, lumbar t-score, lumbar z-score, PTH, calcium, phosphorus, P1 NP and βCTX. Results: Pre-surgery concentrations of both markers were elevated (P1 NP: 90.71 ±5.03; βCTX: 1.52±0.44). A significant decrease was observed in mean post-operative βCTX and P1 NP concentrations (p<0.0001). Levels of BMD, t-score and z-score at lumbar spine were relatively low (BMD: 0.75±0.16; z-score −0.90±0.23; t-score −2.51 ±0.32); after PTX a significant increase was observed in the levels of these three parameters. P1NP and βCTX were correlated with lumbar BMD change one year after PTX (P1 NP: r=0.79, p=0.016; βCTX: r=0.89, p=0.003). Conclusions: Pre-surgery concentrations of both bone markers were elevated and a significant decrease after PTX was found. Serum βCTX and P1NP levels were potently related to lumbar BMD changes over one year after PTX. The measurement of βCTX and P1 NP would be useful to predict long-term changes in lumbar BMD after PTX.

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Authors and Affiliations

  1. Division of Endocrine Surgery, Department of General and Digestive Surgery, “12 de Octubre” University Hospital, Complutense University of Madrid, Madrid, Spain

    S. Alonso PhD, E. Ferrero, M. Donat, M. Hidalgo & E. Moreno

  2. Department of Endocrinology and Metabolism, “12 de Octubre” University Hospital, Complutense University of Madrid, Madrid, Spain

    G. Martínez

  3. Department of Clinical Biochemistry and Clinical Analyses, “12 de Octubre” University Hospital, Complutense University of Madrid, Madrid, Spain

    C. Vargas

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  1. S. Alonso PhD
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  2. E. Ferrero
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  3. M. Donat
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  4. G. Martínez
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Correspondence to S. Alonso PhD.

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Alonso, S., Ferrero, E., Donat, M. et al. The usefulness of high pre-operative levels of serum type I collagen bone markers for the prediction of changes in bone mineral density after parathyroidectomy. J Endocrinol Invest 35, 640–644 (2012). https://doi.org/10.3275/7923

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