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- Title
Diagnostic value of serum peptides of collagen synthesis and degradation in dialysis renal osteodystrophy.
- Authors
Mazzaferro, S.; Pasquali, M.; Ballanti, P.; Bonucci, E.; Costantini, S.; Chicca, S.; De Meo, S.; Perruzza, I.; Sardella, D.; Taggi, F.; Coen, G.
- Abstract
The assay of serum peptides of bone collagen formation and degradation could potentially provide an indirect estimate of the rate of bone turnover. In our study we have measured serum levels of the carboxy-terminal propeptide of type I procollagen (PICP) as a marker of bone formation and serum levels of the pyridinoline cross-linked telopeptide domain of type I collagen (ICTP) as a marker of bone resorption in 53 patients (47.7 ± 10 years, M ± SD) on haemodialysis (for 9.5 ± 3.8 years) and affected by renal osteodystrophy. Besides PICP and ICTP, patients were also sampled for serum intact and C-terminal PTH, osteocalcin (BGP) and alkaline phosphatase (AP). A transiliac bone biopsy for histomorphometry was also performed in all. As expected both PTH assays, BGP and AP, were correlated reciprocally and to histomor-phometric parameters. As for serum levels of PICP, they were on average increased (268.5 ± 104.9 ng/ml, M ± SD) compared to normals (range 66-176), but not correlated to classical humoral markers of hyper-parathyroidism (PTH and AP), with the exception of BGP (with a rather low value: 0.365, <0.01), nor to histomorphometric indices of bone resorption and formation. As far as serum levels of ICTP are concerned, they were on average markedly increased (173.7 ± 126.3, ng/ml; M ± SD) compared to normals (range 1.8−5.0 ng/ml), and positively correlated to AP ( = 0.816, <0.001), BGP (0.707, <0.001), intact PTH ( = 0.735, <0.001), c-term PTH ( = 0.472, <0.01) and to histomorphometric indices of bone resorption (e.g. OcS/BS, = 0.598, <0.001) and formation (e.g. BFR/BS, = 0.713, <0.001). In our hands the assay was at least as useful as other humoral markers like AP and BGP in identifying patients with a low turnover condition or with prevailing hyperpara-thyroidism. As a conclusion serum levels of ICTP, as a marker of collagen breakdown, represent a new and potential diagnostic tool in dialysis renal osteodystrophy, while serum levels of PICP appear to be of less clinical significance.
- Publication
Nephrology Dialysis Transplantation, 1995, Vol 10, Issue 1, p52
- ISSN
0931-0509
- Publication type
Article