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Deoxypyridinoline (Dpd) Cross-links (Serial Monitor)
CPT:
82523; 82570
Test Includes
Long-term serial monitoring of results; color graphic summary report
Special Instructions
The account must submit the patient's Social Security number to monitor. Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy.
Expected Turnaround Time
4 - 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Urine
Volume
10 mL
Minimum Volume
1 mL
Container
Plastic urine container, no preservative
Collection
Collection before 10 AM is recommended (eg, first morning void). Do not add preservative.
Storage Instructions
Refrigerate.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 14 days |
Refrigerated | 14 days |
Frozen | 14 days |
Freeze/thaw cycles | Stable x3 |
Causes for Rejection
Gross hemolysis; gross icterus
Test Details
Use
The Dpd test can be used as a tool to assess bone resorption rates in healthy individuals and in patients with enhanced risk of developing metabolic bone disease. Significantly high levels of Dpd are found in children, in postmenopausal women due to estrogen deficiency, and in patients with diseases that have high bone turnover rates. Dpd can be used to monitor antiresorptive therapies in postmenopausal women and in individuals diagnosed with osteoporosis.
Limitations
This test has not been established to predict development of osteoporosis or future fracture risk.
Methodology
Immunochemiluminometric assay (ICMA)
Reference Interval
• Pediatric:1
− Prepubertal (Tanner Stage I): <41.8 nmol Dpd/mmol creatinine
− Pubertal (Tanner Stage II to IV): <83.5 nmol Dpd/mmol creatinine
• Adults: 2.3−7.4 nmol Dpd/mmol creatinine
Additional Information
Bone is constantly undergoing a process of remodeling that consists of degradation, or resorption, mediated by osteoclasts and rebuilding mediated by osteoblasts. This process is tightly coupled in individuals with healthy bone metabolism. In certain conditions, the rate of resorption exceeds the rate of rebuilding resulting in a net loss of bone. Deoxypyridinoline (Dpd) is a crosslink of type 1 collagen that provides tensile strength to the collagen matrix of bone. Dpd is released into circulation during bone resorption and is excreted unmetabolized into urine. Since Dpd levels are not affected by diet or physical exercise, urinary Dpd concentrations reflect the true rate of bone turnover.
Footnotes
1. Conti A, Ferrero S, Giambona S, Sartorio A. Urinary free deoxypyridinoline levels during childhood. J Endocrinol Invest. 1998 May; 21(5):318-322. 9648054
References
Delmas PD. Biochemical markers for the assessment of bone turnover. In: Riggs BL, Melton LJ III, eds. Osteoporosis: Etiology, Diagnosis, and Management. 2nd ed. Philadelphia, Pa: Lippincott-Raven;1995:319-333.
Miller PD, Baran DT, Bilezikian JP, et al. Practical clinical application of biochemical markers of bone turnover: Consensus of an expert panel. J Clin Densitom. 1999 Fall; 2(3):323-342 (review). 10548827
National Osteoporosis Foundation. Fast Facts on Osteoporosis. Washington, DC: National Osteoporosis Foundation;1994.
National Osteoporosis Foundation. Fast Facts on Osteoporosis, Arthritis, and Osteoarthritis. Washington, DC: National Osteoporosis Foundation;1991.
National Osteoporosis Foundation. The Older Person's Guide to Osteoporosis. Washington, DC: National Osteoporosis Foundation;1993.
Robins SP, Woitge H, Hesley R, Ju J, Seyedin S, Seibel MJ. Direct, enzyme-linked immunoassay for urinary deoxypyridinoline as a specific marker for measuring bone resorption. J Bone Miner Res. 1994 Oct; 9(10)1643-1649. 7817812
Rosen HN, Dresner-Pollak R, Moses AC, et al. Specificity of urinary excretion of cross-linked N-telopeptides of type I collagen as a marker of bone turnover. Calcif Tissue Int. 1994 Jan; 54(1):26-29. 8118749
Ross PD, Knowlton W. Rapid bone loss is associated with increased levels of biochemical markers. J Bone Miner Res. 1998 Feb; 13(2):297-302. 9495524
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 511105 | Deoxypyridinoline (Serial) | 27424-1 | 511611 | Deoxypyridinoline | nmol/L | 27424-1 |
| 511105 | Deoxypyridinoline (Serial) | 27424-1 | 013672 | Creatinine, Urine | mg/dL | 2161-8 |
| 511105 | Deoxypyridinoline (Serial) | 27424-1 | 511612 | DPD/Crt Ratio | nmol/mmol cr | 25095-1 |
| 511105 | Deoxypyridinoline (Serial) | 27424-1 | 511958 | 80563-0 |
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