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Bone Abstracts (2014) 3 PP237 | DOI: 10.1530/boneabs.3.PP237

Osteoporosis: evaluation and imaging

Reference intervals for bone turnover markers in Spanish premenopausal women

Nuria Guañabens1, Xavier Filella1, Ana Monegal1, Carmen Gomez-Vaquero2, Maria Bonet3, Dolors Buquet4, Enrique Casado5, Dacia Cerda6, Alba Erra7, Silvia Martinez8, Nuria Montala9, Concepcion Pitarch10, Eduardo Kanterewickz11, Miquel Sala12, Xavier Suris13, Ferran Torres14 & Lab Oscat Study Group Societat Catalana de Reumatoloía15

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1Hospital Clinic, Barcelona, Spain; 2Hospital Universitari Bellvitge, L’Hospitalet, Spain; 3Hospital de l’Alt Penedes, Villafranca, Spain; 4Hospital Arnau Vilanova, Lleida, Spain; 5Hospital Parc Tauli, Sabadell, Spain; 6Hospital Moises Broggi, Barcelona, Spain; 7Hospital Sant Rafael, Barcelona, Spain; 8Hospital Mutua de Terrassa, Terrassa, Spain; 9Hospital Santa Maria, Lleida, Spain; 10Hospital Esperit Sant, Badalona, Spain; 11Hospital de Vic, Vic, Spain; 12Hospital de Figueras, Figueras, Spain; 13Hospital de Granollers, Granollers, Spain; 14Universitat Autonoma, Barcelona, Spain; 15SCR, Catalunya, Spain.


Background and aims: Bone turnover markers (BTMs) are used in clinical practice for assessing patients with osteoporosis and their treatment. In Spain it is necessary to fine-tune the reference intervals, since they were established years ago in a low number of individuals. The aims of this study were to establish robust reference intervals for BTMs in healthy young premenopausal Spanish women and to investigate the factors influencing BTMs.

Methods: 185 women aged 35–45 years. from 13 centres in Catalonia were recruited. Blood and second void urine samples were collected between 0800 and 1000 h after an overnight fast. Serum PINP and βCTX were measured by two automated methods (Elecsys, Rochea and IDS-ISYS, Immunodiagnostic Systemsb), bone ALP by ELISA (IDS, Vitro), osteocalcin by IRMA (Cis Bio) and urinary NTX by ELISA (Osteomark, Vitro). PTH and 25OHD levels were measured in all participants, who completed a questionnaire on lifestyle factors. A quantile regression was fit to estimate the 5, 50 and 95% percentiles for the BMTs, and the Fisher’s exact test and non-parametric tests were used to assess the influence of factors on BTMs.

Results: Reference intervals are shown in the Table 1.

Oral contraceptive pills (OCPs) were reported in 10.9% of participants, mean BMI was 23 and 60% had 25OHD levels lower than 20 ng/ml. Women on OCPs had lower PINP levels (P=0.007). 25OHD levels didn’t influence BTMs, but low BMI was associated with higher levels of almost all BTMs.

Table 1 Reference intervals
Bone ALP (ng/ml)PINPa (ng/ml)PINPb (ng/ml)NTX (nM/mM)CTXa (ng/ml)CTXb (ng/ml)Osteocalcin (ng/ml)
Median 9.335.935.832.70.2500.24614.0
P5 6.020.820.819.30.1370.1078.0
P95 13.860.664.968.90.4800.54123.0

In conclusion, robust reference intervals for BTMs in a southern European country are provided.

Volume 3

European Calcified Tissue Society Congress 2014

Prague, Czech Republic
17 May 2014 - 20 May 2014

European Calcified Tissue Society 

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