Clinical Usefulness of Urinary CrossLaps as a Sensitive Marker of Bone Metabolism.

Nakayama H, Hirotoshi Nakayama, H Nakayama, Yano T, Tetsu Yano, T Yano, Yoko Sagara, Y Sagara, Sagara Y, Ando K, K Ando, KAYO ANDO, Yasuyo Kasai, Y Kasai, Kasai Y, Taketani Y, Y Taketani, Yuji Taketani
Endocrine journal · 1997 · vol. 44(4) , pp. 479–484 · doi:10.1507/endocrj.44.479 · PMID:9447279 · W2051055519
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Urinary CrossLaps levels significantly increased with GnRH agonist therapy, showing a greater response than other bone resorption markers and inversely correlating with bone mineral density loss.

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The study evaluated whether urinary CrossLaps, a marker of bone collagen degradation, could sensitively reflect bone turnover during 6 months of gonadotropin-releasing hormone (GnRH) agonist therapy in 11 premenopausal women treated for adenomyosis (n=1) or leiomyomas (n=10). Urinary CrossLaps and other bone turnover markers (including resorption markers such as pyridinoline, deoxypyridinoline, and hydroxyproline, and formation markers such as serum osteocalcin and bone-specific alkaline phosphatase) were measured alongside estradiol, calcitonin, and intact parathyroid hormone, while lumbar spine bone mineral density (BMD) was tracked. Estradiol became undetectable by 2 months, all biochemical markers increased significantly, and the increase in CrossLaps was greater than that of the other markers; lumbar spine BMD decreased by 7.2% at 6 months with an inverse correlation between BMD change and CrossLaps change at multiple time points. A major limitation is the very small adenomyosis subgroup and overall small sample size. This paper is centrally about adenomyosis — it includes adenomyosis patients receiving GnRH agonist therapy and examines bone loss and urinary CrossLaps changes in that treatment context.

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Abstract

CrossLaps peptide [Glu-Lys-Ala-His-Asp-Gly-Gly-Arg], a part of the C-telopeptide of the alpha 1-chain of type I collagen of bone, is a recently developed biochemical marker of bone turnover. In this study, the clinical utility of measurement of urinary CrossLaps was investigated in eleven premenopausal women who received a gonadotropin-releasing hormone (GnRH) agonist for 6 months for treatment of adenomyosis (n = 1) or leiomyomas (n = 10). Along with urinary CrossLaps, the levels of various biochemical markers, and serum estradiol, calcitonin and intact parathyroid hormone (i-PTH) were measured, and lumbar spine bone mineral density (BMD) was also monitored before, during, and at the end of the course of GnRH agonist therapy. Apart from CrossLaps, markers of bone resorption tested were urinary pyridinoline, deoxypyridinoline and hydroxyproline. Markers of bone formation tested were serum osteocalcin and bone-specific alkaline phosphatase (B-ALP). Serum estradiol levels decreased to undetectable levels at 2 months of GnRH agonist therapy. The values for all biochemical markers increased significantly throughout the therapy. The degree of an increase in CrossLaps levels was greater than that in all other markers. Mean lumbar spine (L2-L4) BMD was decreased by 7.2% at 6 months of treatment. The percent change in BMD at 6 months of treatment correlated inversely with the percent change in CrossLaps levels from the baseline to 1, 2, and 5 months of treatment. These results indicate that measurement of urinary CrossLaps might be a useful tool to predict the risk of bone loss caused by hypoestrogenism including GnRH agonist therapy.
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Keywords

Bone metabolism, Bone mineral density (BMD), CrossLaps, Gonadotropin-releasing hormone (GnRH) agonist 1997 Volume 44 Issue 4 Pages 479-484 Details

Abstract

CrossLaps peptide [Glu-Lys-Ala-His-Asp-Gly-Gly-Arg], a part of the C-telopeptide of the α1-chain of type I collagen of bone, is a recently developed biochemical marker of bone turnover. In this study, the clinical utility of measurement of urinary CrossLaps was investigated in eleven premenopausal women who received a gonadotropin-releasing hormone (GnRH) agonist for 6 months for treatment of adenomyosis (n=1) or leiomyomas (n=10). Along with urinary CrossLaps, the levels of various biochemical markers, and serum estradiol, calcitonin and intact parathyroid hormone (i-PTH) were measured, and lumbar spine bone mineral density (BMD) was also monitored before, during, and at the end of the course of GnRH agonist therapy. Apart from CrossLaps, markers of bone resorption tested were urinary pyridinoline, deoxypyridinoline and hydroxyproline. Markers of bone formation tested were serum osteocalcin and bone-specific alkaline phosphatase (B-ALP). Serum estradiol levels decreased to undetectable levels at 2 months of GnRH agonist therapy. The values for all biochemical markers increased significantly throughout the therapy. The degree of an increase in CrossLaps levels was greater than that in all other markers. Mean lumbar spine (L2-L4) BMD was decreased by 7.2% at 6 months of treatment. The percent change in BMD at 6 months of treatment correlated inversely with the percent change in CrossLaps levels from the baseline to 1, 2, and 5 months of treatment. These results indicate that measurement of urinary CrossLaps might be a useful tool to predict the risk of bone loss caused by hypoestrogenism including GnRH agonist therapy. © The Japan Endocrine Society Favorites & Alerts Recently viewed articles Predecessor

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Condition tags

adenomyosis

MeSH descriptors

Bone and Bones Bone Resorption Collagen Peptide Fragments Receptors, LHRH Adenomyoma Adenomyoma Adult Biomarkers Biomarkers Bone and Bones Bone Resorption Bone Resorption Bone Resorption Collagen Female Humans Leiomyoma Leiomyoma Middle Aged

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