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Serum tartrate-resistant acid phosphatase 5b in monitoring bisphosphonate treatment with clodronate: a comparison with urinary N-terminal telopeptide of type I collagen and serum type I procollagen amino-terminal propeptide

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Abstract

Osteoclastic tartrate-resistant acid phosphatase activity in serum (S-TRACP 5b) was measured in postmenopausal women ( n =59, mean age 56.1 years) with vertebral osteopenia before and during 2-year treatment with an 800-mg daily dose of clodronate, with a non-amino bisphosphonate. Changes in TRACP 5b were compared with those in urinary excretion of type I collagen amino-terminal telopeptide (U-NTX), corrected for creatinine excretion, a well-established marker of bone resorption, and to serum type I procollagen amino-terminal propeptide (S-PINP), a marker of bone formation. Marker changes 1 year after start of treatment were correlated with changes in bone mineral density (BMD). The least significant change (LSC) for each marker and BMD was calculated from values for subjects receiving placebo. Responders to treatment were those exhibiting a change larger than LSC. In response to clodronate treatment S-TRACP 5b (mean change up to −18%) decreased less than did U-NTX (up to −51%) or S-PINP (up to −46%). Marker changes correlated with changes in lumbar spine and trochanter BMD. The most efficient marker for finding responders to treatment was S-PINP, which changed more than the LSC (32%) in 72% of the subjects at the 1-year time point and in 79% at the 2-year time point. S-TRACP 5b change exceeded the LSC (27%) in 40% and 34% of the subjects at each time point, while U-NTX change exceeded the LSC (55%) in 55% and 40%, respectively. We conclude that, in terms of the proportion of subjects exhibiting any change exceeding the LSC, S-TRACP 5b did not appear to be superior to U-NTX and S-PINP in the follow-up of clodronate treatment. The reason may lie in the mechanism of action of clodronate, which rather than reducing the number of TRACP 5b-secreting osteoclasts, reduces the activity of bone proteolytic enzymes and thus the rate of bone organic matrix degradation. This is seen in decreased amounts of type I collagen breakdown products (U-NTX), and through coupling of bone resorption with bone formation, in a decrease in circulating levels of the marker that reflects new collagen formation (S-PINP).

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Notes

  1. Beta-isomerized form of the cross-link region peptide from the type I collagen carboxy-terminal telopeptide

  2. The alpha-isomerized form of CTX

  3. Cross-linked carboxy-terminal telopeptide of type I collagen produced by matrix metalloproteinases

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Acknowledgment

We thank Suomen Bioanalytiikka Oy for providing us with reagents for TRACP 5b measurement

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Authors and Affiliations

  1. Mehiläinen Oy Laboratoriopalvelut, Runeberginkatu 47, 00330, Helsinki, Finland

    Riitta Tähtelä

  2. Finnish Cancer Registry, Helsinki, Finland

    J. Seppänen

  3. Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    K. Laitinen & M. J. Välimäki

  4. United Laboratories Ltd, Helsinki, Finland

    A. Katajamäki & M. J. Välimäki

  5. Department of Clinical Chemistry, Oulu University Hospital, Oulu, Finland

    J. Risteli

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  1. Riitta Tähtelä
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  2. J. Seppänen
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  3. K. Laitinen
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  4. A. Katajamäki
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  5. J. Risteli
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Correspondence to Riitta Tähtelä.

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Tähtelä, R., Seppänen, J., Laitinen, K. et al. Serum tartrate-resistant acid phosphatase 5b in monitoring bisphosphonate treatment with clodronate: a comparison with urinary N-terminal telopeptide of type I collagen and serum type I procollagen amino-terminal propeptide. Osteoporos Int 16, 1109–1116 (2005). https://doi.org/10.1007/s00198-004-1819-7

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  • DOI: https://doi.org/10.1007/s00198-004-1819-7

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