| The significance of serum C-telopeptide as a bone marker in chronic hemodialysis patients |
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Chang Sook Lee, R.N., Sung Chul Yoon |
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| 만성 혈액투석 환자의 골대사지표로써 telopeptide 측정 의의 |
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이창숙, 윤성철, Sung Chul Yoon |
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| Abstract |
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Background/Aims: Checking bone mineral density (BMD) is not sufficient for determining the progression of renal osteodystrophy.
Measuring pyridinoline or deoxypyridinoline in urine does not give an accurate bone status, due to insufficient urine in patients
with renal failure. However, another biochemical marker, beta-CTX (the carboxy-terminal telopeptide of type 1 collagen), in
serum is believed to be a good indicator of the status of renal osteodystrophy.
Methods: Fifty-nine patients undergoing hemodialysis agreed to have their blood and BMD checked. Beta-CTX was measured
using an electro-chemiluminescence sandwich immunoassay and BMD was counted at the lumbar spine, femoral neck, and distal
humerus using a Discovery-Wi (Hologic).
Results: Bone-alkaline phosphatase (49.8±36.7 U/L), parathormone (PTH) (192.8±263.3 U/L), osteocalcin (33.4±18.2 ng/mL),
and beta-CTX (2.1±1.2 ng/mL) were all increased, while the average BMD of the lumbar spine (0.86±0.17), femoral neck,
(0.67±0.14) and distal humerus (0.67 ± 0.17) were all decreased. The BMD of the femoral neck in females was significantly lower
than in males (p=0.044). The serum phosphate and PTH concentrations in non-diabetics were significantly higher than in diabetics
(p=0.001, p=0.04, respectively). The measured serum osteocalcin and beta-CTX concentrations in patients older than 40 years were
much lower than in patients younger than 40 (p=0.009, p=0.01, respectively). Beta-CTX was strongly correlated with bone-alkaline
phosphatase (r=0.625, p=0.00), osteocalcin (r=0.698, p=0.00), and PTH (r=0.648, p=0.00).
Conclusions: Beta-CTX is another convenient, significant marker for evaluating renal osteodystrophy. (Korean J Med 76:443-
450, 2009) |
| Key Words:
C-telopeptide; Renal osteodystrophy; Hemodialysis; Bone resorption |
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