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Diurnal, Week‐to‐Week, and Long‐Term Variation in Urine Deoxypyridinoline Cross‐Link Excretion in Healthy Older Women
Author(s) -
Allain Theresa J.,
Abraha Hagosa D.,
Ouldred Emma L.,
Ajmal Raheela,
BuxtonThomas Muriel S.,
Gray Beverley C.,
Jackson Stephen H. D.,
Blackburn Ann M.,
Moniz Caje F.
Publication year - 2002
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2002.50518.x
Subject(s) - morning , medicine , diurnal temperature variation , creatinine , deoxypyridinoline , excretion , urine , biochemistry , chemistry , alkaline phosphatase , atmospheric sciences , osteocalcin , enzyme , geology
OBJECTIVES: To establish a reference range for morning and afternoon excretion of urinary deoxypyridinoline (DPD) in apparently healthy older women selected from a volunteer database. To assess the extent of diurnal variation and short and long‐term within‐subject longitudinal variation. DESIGN: Prospective, observational, cohort study. SETTING: Clinical Age Research Unit, King's College School of Medicine, London, United Kingdom. PARTICIPANTS: Forty‐two women aged 68 to 89 (median age 75) selected from a volunteer database. METHODS: Subjects completed an osteoporosis risk factor questionnaire and a physical examination and had a measurement of the broadband ultrasound attenuation and speed of sound of their right heel. Subjects provided six urine samples: morning and afternoon at baseline and 1 week and 60 weeks later for measurement of DPD. RESULTS: The mean baseline values for DPD of morning and afternoon samples were 7.2 nM/mM and 6.0 nM/mM creatinine, respectively. The majority of subjects showed diurnal variation, with mean afternoon values 15% lower than morning values ( P < . 0001 for afternoon vs morning values). The mean difference in DPD after 60 weeks was 1.67 nM/mM for morning and 1.34 nM/mM for afternoon creatinine. This difference was not significant. Some individuals displayed marked changes in DPD excretion with no change in health status or treatment. DPD excretion in a nonfasting afternoon sample showed similar characteristics to morning void samples in terms of scatter, week‐to‐week variation, and long‐term reproducibility. CONCLUSIONS: The study was set up to provide background data to assist the development of a clinical osteoporosis service for older women. Further studies are needed to determine whether these measurements predict fracture risk and respond to treatment changes in this age group.