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C-Terminal Telopeptide (CTX-I)

C-Terminal Telopeptide (CTX-I)

Overview
C-terminal telopeptide (CTX-I) is a peptide fragment released during the breakdown of type I collagen, a major component of bone. It serves as a biomarker for bone resorption, reflecting osteoclast activity and bone turnover rates.

Key Applications

1. Osteoporosis Management
   • Monitors response to bisphosphonates or hormone replacement therapy.
   • Low CTX-I levels (<150–200 pg/mL) indicate suppressed bone turnover, linked to risks like osteonecrosis of the jaw (ONJ) after dental procedures13.
   • Guides “drug holidays”: CTX-I increases ~25 pg/mL monthly after stopping bisphosphonates3.
2. Cancer Metastasis Detection
   • Elevated levels aid in identifying skeletal metastases (e.g., breast/prostate cancer) and monitoring Paget’s disease4.
3. Fracture Risk Assessment
   • Correlates with bone loss severity; lower levels may predict poor healing15.

Measurement and Considerations

• Sample Types: Serum (preferred), plasma, or urine.
• Circadian Rhythm: Levels peak in the early morning; fasting samples minimize variability5.
• Assay Variability: Results differ between methods; standardization challenges exist5.
• Reference Ranges:
  • Healthy adults: Typically 300–550 pg/mL (serum).
  • Risk threshold: <150–200 pg/mL suggests high ONJ risk in bisphosphonate users3.

Clinical Implications

• Dental Surgery: CTX-I <150 pg/mL may warrant bisphosphonate cessation pre-surgery3.
• Therapy Monitoring: Rising CTX-I indicates resumed bone turnover, reducing complication risks1.

Limitations

• Not predictive for individual ONJ cases but identifies population risk3.
• Requires correlation with clinical context due to assay variability5.

CTX-I is a critical tool for evaluating bone health, optimizing treatment strategies, and mitigating risks in high-turnover conditions.

Consult with Our Team of Experts Now!
At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about C-Terminal Telopeptide (CTX-I) or would like more information on our services, consult with our experts today!

Consult with Our Team of Experts Now!

References:

• Vasikaran SD, Eastell R, Bruyère O, et al. “Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards.” Osteoporosis International. 2011;22(2):391–420.
  DOI: 10.1007/s00198-010-1501-1