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Titolo:
A SINGLE MEASUREMENT OF BIOCHEMICAL MARKERS OF BONE TURNOVER HAS LIMITED UTILITY IN THE INDIVIDUAL PERSON
Autore:
JENSEN JEB; KOLLERUP G; SORENSEN HA; NIELSEN SP; SORENSEN OH;
Indirizzi:
UNIV COPENHAGEN,MUNICIPAL HOSP,OSTEOPOROSIS RES CTR,OSTER FARIMAGSGADE 5 DK-1399 COPENHAGEN K DENMARK
Titolo Testata:
Scandinavian journal of clinical & laboratory investigation
fascicolo: 4, volume: 57, anno: 1997,
pagine: 351 - 359
SICI:
0036-5513(1997)57:4<351:ASMOBM>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYDROXYPYRIDINIUM CROSS-LINKS; POSTMENOPAUSAL WOMEN; BIOLOGICAL VARIATION; OSTEOPOROSIS; MASS; ALENDRONATE; MENOPAUSE; COLLAGEN; RESORPTION; CALCITONIN;
Keywords:
BIOCHEMICAL BONE MARKERS; BIOLOGICAL VARIATION; CRITICAL DIFFERENCE; INDEX OF INDIVIDUALITY; NUMBER OF SAMPLES; PREDICTIVE VALUE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
38
Recensione:
Indirizzi per estratti:
Citazione:
J.E.B. Jensen et al., "A SINGLE MEASUREMENT OF BIOCHEMICAL MARKERS OF BONE TURNOVER HAS LIMITED UTILITY IN THE INDIVIDUAL PERSON", Scandinavian journal of clinical & laboratory investigation, 57(4), 1997, pp. 351-359

Abstract

Biochemical markers of bone turnover are used to estimate the rate ofbone loss in the individual osteoporotic patient. During recent yearsit has become increasingly clear that the biological variability of biochemical bone markers has to be taken into consideration in the evaluation of their usefulness in the clinical setting. Eleven premenopausal, 8 perimenopausal and 11 postmenopausal healthy women were included. We assessed the analytical and the biological components of variation for a number of resorptive and formative bone markers: u-hydroxyproline, u-pyridinoline, and u-deoxypyridinoline together with u-calcium and u-creatinine, s-total alkaline phosphatases and s-osteocalcin. Blood and urine samples were collected five times with 7-day intervals. Urinary parameters were expressed as outputs and corrected for creatinine in fasting night urines and second void fasting morning urines. The absolute values differed with a tendency towards increasing values in the postmenopausal women, but the biological variations in relation tomenopausal status were not different. The biological variability was much higher for the urinary resorptive markers than for the formative markers in the blood. The critical difference expressing the difference needed between two serial results from the same person to be significant at a 5% level was 15% for s-alkaline phosphatases, 18% for s-osteocalcin, and lowest in the second void fasting morning urines with values of 28% and 34% for u-pyridinoline/creatinine and u-deoxypyridinoline/creatinine, and 50 % and 112 % for u-hydroxyproline/creatinine and u-calcium/creatinine, respectively. The index of individuality, denoting the individual variation divided by the variation between subjects,was in the range from 0.19 for s-alkaline phosphatases to 1.23 for u-hydroxyproline/minute in second void fasting morning urine making the use of conventional reference intervals difficult. Low indices, however, indicate high test performance and offer the possibility of stratification of persons within a range. The number of samples required to determine the true individual mean value +/-5% for the single person, ranged from 5 for s-total alkaline phosphatases, 6 for s-osteocalcin, 23 for u-deoxypyridinoline/creatinine in the fasting morning urine to over two hundred for u-calcium analytes; It is concluded that, due to high biological variation, a single measurement of biochemical markers of bone turnover is of limited utility in the individual person. We recommend that routine clinical use of biochemical markers should be restricted until further evidence justifies it.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 14:23:35