Exp Clin Endocrinol Diabetes 2006; 114(9): 506-510
DOI: 10.1055/s-2006-951627
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG · Stuttgart · New York

Biochemical Markers of Bone Turnover during Pregnancy: A Longitudinal Study

L. Hellmeyer 1 , V. Ziller 2 , G. Anderer 2 , A. Ossendorf 2 , S. Schmidt 1 , P. Hadji 2
  • 1Department of Obstetrics and Perinatal medicine, Philipps-University of Marburg
  • 2Department of Endocrinology, Osteoporosis and Reproductive medicine, Philipps-University of Marburg
Further Information

Publication History

Received: November 30, 2005 First decision: September 6, 2006

Accepted: July 19, 2006

Publication Date:
17 November 2006 (online)

Abstract

Objective: The objective of this study was to prospectively investigate the effect of pregnancy on biochemical markers of bone turnover in healthy pregnant women. Methods: During the course of our longitudinal study, biochemical markers of bone remodeling were measured in all three trimester of pregnancy (first trimester: 12.5±1.8 SD, second trimester: 21.6±1 SD, third trimester: 34.8±1.6 SD weeks of gestation). Serum type I collagen C-telopeptides (CTX) and a crosslinked peptide of the carboxy-terminal telopeptide of type I collagen (ICTP) were used as markers of bone resorption. Bone alkaline phosphatase (BAP) and the N-terminal propeptides of type I collagen (PINP) were used as biochemical markers of bone formation. Blood samples for the analysis of all 4 biochemical markers according to each trimester of pregnancy were available in 49 patients. Results: The main changes for all biochemical markers were seen between the second and the third trimester. According to the markers of bone resorption, both serum CTX and ICTP showed a significant increase from the first to the third and from the second to the third trimester (p<0.001; median percentage change: CTX=101.5% and ICTP=40%). Concerning markers of bone formation, PINP showed a significant decrease from the first to the second trimester (p=0.001) followed by a significant increase from the second to the third trimester (p<0.001, 63.8%) and an overall increase from the first to the third trimester (p<0.001). BAP also showed a significant increase from the second to the third trimester (p<0.001; 51.7%) and an overall increase from the first to the third trimester (p<0.001). Conclusion: Markers of bone resorption were significantly increased during pregnancy. In contrast to bone resorption, markers of bone formation showed an increase as well as a decrease during pregnancy indicating a state of high bone turnover. This might coincide with the change in bone mineral density that was observed in some, but not all, studies using “dual-energy x-ray absorptiometry” (DXA) as well as “quantitative ultrasonometry” (QUS).

References

Correspondence

Dr. med. Lars Hellmeyer

Dpt. of obstetrics and perinatal medicine·Philipps-University of Marburg

Pilgrimstein 3

35037 Marburg

Germany

Phone: +06421/28 64 40 4

Email: hellmeye@med.uni-marburg.de