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Cartilage turnover assessed with a newly developed assay measuring collagen type II degradation products: influence of age, sex, menopause, hormone replacement therapy, and body mass index

U Mouritzen¹, S Christgau^1,2, H-J Lehmann¹, L B Tankó, C Christiansen

¹ Centre for Clinical and Basic Research A/S, Ballerup, Denmark
² Nordic Bioscience A/S, Herlev, Denmark

Correspondence to:
Correspondence to:
Dr U Mouritzen, Centre for Clinical and Basic Research A/S, Ballerup Byvej 222, DK-2750 Ballerup, Denmark;
ig{at}ccbr.dk

Background: Cartilage normally has a slow turnover but in arthritis increased metabolism results in degradation of the tissue.

Objective: To assess cartilage turnover in a sample of the general population by an assay measuring cartilage derived urinary collagen type II (CTX-II) C-telopeptide degradation products.

Methods: CTX-II concentrations were measured in urine samples from 615 healthy men and women aged 20–87 years, and the influence of age, sex, menopause, hormone replacement therapy (HRT), and body mass index (BMI) was assessed.

Results: CTX-II concentrations showed age dependent variations, with notable differences between men and women. Mean (SD) CTX-II concentration in postmenopausal women (220 (118) ng/mmol, n=25) was significantly higher than in an age matched group of premenopausal women (112 (79) ng/mmol, n=26, p<0.001). CTX-II concentration in women using HRT (118 (57) ng/mmol, n=50) was significantly lower than in an age and BMI matched group of women not receiving HRT (215 (99) ng/mmol, n=50, p<0.001). In subjects with a BMI 25 kg/m², CTX-II concentrations were significantly higher than in those with a BMI <25 kg/m² (185 (114) v 148 (91) ng/mmol, p<0.001).

Conclusions: Cartilage turnover, as assessed by measuring urinary degradation products of CTX-II varies considerably with age, and significant differences between CTX-II levels in men and women as well as in pre- and postmenopausal women are found. Further studies are required to validate the marker for assessing cartilage degradation in arthritis.

Keywords: cartilage; collagen; biological markers; osteoarthritis

Abbreviations: BMI, body mass index; CTX-II, collagen type II; ELISA, enzyme linked immunosorbent assay; HRT, hormone replacement therapy; OA, osteoarthritis; RA, rheumatoid arthritis

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