J Bone Metab.  2020 Feb;27(1):43-52. 10.11005/jbm.2020.27.1.43.

Reference Intervals for Bone Turnover Markers in Korean Healthy Women

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. djchung@chonnam.ac.kr
  • 2Department of Health Administration, Kwangju Women's University, Gwangju, Korea.

Abstract

BACKGROUND
Adequate suppression of bone turnover rate is important to decrease fracture risk without mineralization defect due to oversuppression. This study was performed to determine reference intervals (RIs) for 2 bone turnover markers, serum C-terminal telopeptide of type I collagen (CTX) and osteocalcin, in Korean women.
METHODS
A total of 461 Korean women (287 premenopausal and 174 postmenopausal) without any disease or drug history affecting bone metabolism was included. Serum CTX and osteocalcin were measured after overnight fasting. Bone mineral density (BMD) was measured at the 1st to 4th lumbar vertebra using dual energy X-ray absorptiometry. Subjects with normal spinal BMD (T-score ≥−1.0) were included in this study.
RESULTS
After stable concentrations were maintained, both CTX and osteocalcin were abruptly increased in 50 to 59 years, and then decreased with increasing age. Median levels and interquartile range of serum CTX and osteocalcin in all subjects were 0.322 (0.212-0.461) ng/mL and 15.68 (11.38-19.91) ng/mL. RIs for serum CTX and osteocalcin in all subjects were 0.115 to 0.861 ng/mL and 6.46 to 36.76 ng/mL. Those were higher in postmenopausal women (CTX, 0.124-1.020 ng/mL, osteocalcin, 5.42-41.57 ng/mL) than in premenopausal women (CTX, 0.101-0.632 ng/mL, osteocalcin, 6.73-24.27 ng/mL). If we use target reference levels as lower half of premenopausal 30 to 45 years in patients with antiresorptive drugs, those were 0.101 to 0.251 ng/mL and 6.40 to 13.36 ng/mL.
CONCLUSIONS
We established RIs for serum CTX and osteocalcin in healthy Korean women with normal lumbar spine BMD. Premenopausal RIs for serum CTX and osteocalcin would be useful to monitor patients with low bone mass using osteoporosis drugs.

Keyword

Bone remodeling; Osteocalcin; Osteoporosis; Reference values

MeSH Terms

Absorptiometry, Photon
Biomarkers
Bone Density
Bone Density Conservation Agents
Bone Remodeling*
Collagen Type I
Fasting
Female
Humans
Metabolism
Miners
Osteocalcin
Osteoporosis
Reference Values
Spine
Biomarkers
Bone Density Conservation Agents
Collagen Type I
Osteocalcin
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