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C-telopeptide of type I collagen (CTX-1) in premenopausal Egyptian women with fibromyalgia syndrome
Egyptian Rheumatology and Rehabilitation volume 42, pages 80–86 (2015)
Abstract
Introduction
The majority of the fibromyalgia syndrome (FMS) patients do not exercise regularly and their physical fitness is low. Physical inactivity accelerates bone loss. This suggests that FMS patients are at risk in terms of osteoporosis. The aim of this study was to measure serum C-telopeptide of type I collagen (CTX-1) as a marker of bone resorption in premenopausal women with FMS.
Patients and methods
A total of 100 premenopausal female patients with FMS diagnosed according to the American College of Rheumatology (ACR) criteria 1990 and 50 healthy women were chosen to serve as the control group. Serum CTX-1 levels were measured using beta-CrossLaps Roche Elecsys.
Results
The serum CTX-1 level was significantly higher in patients with FMS compared with the control group. The mean serum CTX-1 in FMS patients was 340.2 ± 112.6 pg/ml compared with 283.6 ± 113.1 pg/ml in controls (P = 0.004). The serum CTX-1 level was positively correlated with the visual analogue scale(VAS) of pain (P = 0.028), the VAS of fatigue (P = 0.031), the VAS of global severity (P = 0.016), the VAS of anxiety (P = 0.013), the Health Assessment Questionnaire score (P = 0.022), the Fibromyalgia Impact Questionnaire (P = 0.010), the Beck Depression Inventory (P = 0.007), the tender points count (P = 0.003), the tender points score (P = 0.004), and the Pittsburg Sleep Quality Index (P = 0.021). The mean serum CTX-1 level was also significantly higher in FMS patients with postexertion pain (P = 0.010), confusion (P = 0.025), dizziness (P = 0.012), depression (P = 0.029), mood disturbance (P = 0.018), anxiety (P = 0.030), short memory difficulties (P = 0.017), and sleep disturbance (P = 0.028) than in those without these symptoms.
Conclusion
We found a significant increase in serum CTX-1 in FMS patients compared with controls, and this was correlated with the disease severity. Increased CTX-1 may lead to the early development of osteoporosis. More comprehensive and detailed studies are needed to determine the exact role of CTX-1 in FMS.
References
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria committee. Arthritis Rheum 1990; 33:160–172
Kroger H, Tuppurainen M, Honkanen R, Alhava E, Saarikoski S. Bone mineral density and risk factors for osteoporosis – a population-based study of 1600 perimenopausal women. Calcif Tissue Int 1994; 55:1–7.
Cizza G, Primma S, Coyle M, Gourgiotis L, Csako G. Depression and osteoporosis: a research synthesis with meta-analysis. Horm Metab Res 2010; 42:467–482.
Blake GM, Fogelman I, Blake GM, Fogelman I, Blake GM, Fogelman I. Monitoring treatment for osteoporosis by using bone densitometry. Semin Nucl Med 2001; 31:212–222.
Kanis JA, Delmas P, Burckhardt P, Cooper C, Torgerson D. Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 1997; 7:390–406.
Ofluoglu D, Karadag-Saygi E, Canbulat C, Gunduz OH, Kul-Panza E, Akyuz G. Early effect of nasal salmon calcitonin on the bone marker Crosslaps. Rheumatol Int 2006; 26:288–291.
Brown JP, Josse RG, Scientific Advisory Council of the Osteoporosis Society of Canada. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ 2002; 167(Suppl): S1– S34.
Herrmann M, Seibel MJ. The amino- and carboxyterminal cross-linked telopeptides of collagen type I, NTX-I and CTX-I: a comparative review. Clin Chim Acta 2008; 393:57–75.
Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J, Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis. Committee of Scientific Advisors of the International Osteoporosis Foundation. Osteoporos Int 2000; 11 : Suppl 6:S2-S17.
Wekre LL, Eriksen EF, Falch JA. Bone mass, bone markers and prevalence of fractures in adults with osteogenesis imperfecta. Arch Osteoporos 2011; 6:31–38.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62:600–610.
Huskisson EC. measurement of pain. Lancet 1974; 2:1127–31.
Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol 1991; 18:728–733.
Salen BA, Spangfort EV, Nygren AL, Nordemar R. The disability rating index: an instrument for the assessment of disability in clinical sitting. J Clin Epidemiol 1994; 47:1423–1435.
Fries JF, Spitz PW, Karines RG, Holman HR. Measurement patient outcome in arthritis. Arthritis Rheum 1980; 23:137–145.
Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28:193–213.
Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988; 8:77–100.
Nørregaard J, Bülow PM, Lykkegaard JJ, Mehlsen J, Danneskiold-Samsøoe B. Muscle strength, working capacity and effort in patients with fibromyalgia. Scand J Rehabil Med 1997; 29:97–102.
Riis BJ. Biochemical markers of bone turnover. II: Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993; 95(5A): 17S–21S.
Bonnick SL, Shulman L. Monitoring osteoporosis therapy: bone mineral density, bone turnover markers, or both? Am J Med 2006; 119(Suppl 1): S25–S25S31.
El Maghraoui A, Tellal S, Chaouir S, Lebbar K, Bezza A, Nouijai A, et al. Bone turnover markers, anterior pituitary and gonadal hormones, and bone mass evaluation using quantitative computed tomography in ankylosing spondylitis. Clin Rheumatol 2005; 24:346–351.
Achemlal L, Tellal S, Rkiouak F, Nouijai A, Bezza A, Derouiche el M, et al. Bone metabolism in male patients with type 2 diabetes. Clin Rheumatol 2005; 24:493–496.
Garnero P, Ferreras M, Karsdal MA, Nicamhlaoibh R, Risteli J, Borel O, et al. The type I collagen fragments ICTP and CTX reveal distinct enzymatic pathways of bone collagen degradation. J Bone Miner Res 2003;18:859–867.
Chopin F, Garnero P, le Henanff A, Debiais F, Daragon A, Roux C, et al. Long-term effects of infliximab on bone and cartilage turnover markers in patients with rheumatoid arthritis. Ann Rheum Dis 2008; 67:353–357.
Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 2011; 22:391–420.
Lee J, Vasikaran S. Current recommendations for laboratory testing and use of bone turnover markers in management of osteoporosis. Ann Lab Med2012; 32:105–112.
Appelboom T, Schoutens A. High bone turnover in fibromyalgia. Calcif Tissue Int 1990; 46:314–317.
El Maghraoui A, Tellal S, Achemlal L, Nouijai A, Ghazi M, Mounach A, et al. Bone turnover and hormonal perturbations in patients with fibromyalgia. Clin Exp Rheumatol 2006; 24:428–431.
Jacobsen S, Gam A, Egsmose C, Olsen M, Danneskiold-Samsøe B, Jensen GF. Bone mass and turnover in fibromyalgia. J Rheumatol 1993; 20:856–859.
Ribel-Madsen S, Christgau S, Gronemann ST, Bartels EM, Danneskiold-Samsøe B, Bliddal H. Urinary markers of altered collagen metabolism in fibromyalgia patients. Scand J Rheumatol 2007; 36:470–477.
Sprott H, Müller A, Heine H. Collagen cross-links in fibromyalgia syndrome. Z Rheumatol 1998; 57:Suppl 2:52–55.
Mateos F, Valero C, Olmos JM, Casanueva B, Castillo J, Martínez J, et al. Bone mass and vitamin D levels in women with a diagnosis of fibromyalgia. Osteoporos Int 2014; 25:525–533.
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Olama, S.M., ElSaid, T.O. & El-Arman, M.M. C-telopeptide of type I collagen (CTX-1) in premenopausal Egyptian women with fibromyalgia syndrome. Egypt Rheumatol Rehabil 42, 80–86 (2015). https://doi.org/10.4103/1110-161X.157867
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DOI: https://doi.org/10.4103/1110-161X.157867