Examinations
Examinations
N-Terminal Propeptide of Type I Procollagen (P1NP)
A Key Marker of Bone Metabolism
The use of biochemical markers of bone metabolism, such as P1NP, is an important complement to densitometry (bone mineral density measurement) in the diagnosis and treatment of osteoporosis. Unlike densitometry, which evaluates bone mineralization at the time of measurement, biochemical markers assess the rate and direction of bone metabolism.
Bone Remodeling Process
Bone tissue undergoes two contrasting yet interdependent processes that enable bone remodeling and self-repair:
- Bone resorption – the breakdown and removal of old bone tissue.
- Bone formation – the production of new bone tissue.
These processes preserve bone structure and maintain calcium metabolism.
Hormonal Regulation of Bone Metabolism
Several hormones influence bone metabolism, including:
- Parathyroid hormone (PTH)
- Estrogens
- Thyroid hormones
- Growth hormone
- Glucocorticoids
Age-Related Changes in Bone Turnover
- During growth, bone formation dominates over bone resorption.
- After age 50, bone resorption begins to exceed bone formation, leading to progressive bone loss.
- Accelerated bone metabolism can further increase bone loss and the risk of osteoporosis.
Biomaterial: Venous blood
Pre-test recommendations:
- Fasting for 12 hours before the test
- Discontinuation of medications 24 hours before the test (with physician approval)
- Monitoring anabolic therapy (expected increase in P1NP levels)
- Monitoring antiresorptive therapy (expected decrease in P1NP levels)
- Evaluation of osteoporosis treatment efficacy
- Assessment of metabolic bone disorders
Causes of Increased P1NP Levels
- Osteoporosis(mild increase)
- Age-related osteoporosis(mild increase)
- Osteomalacia
- Defective osteogenesis
- Paget’s disease
- Renal osteodystrophy(slight increase)
- Metastatic bone disease