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To further oversimplify, it seems to me that the ratio of CTX to P1NP might be of value if the goal is to maintain a steady state of bone tear-down and bone building. Using the values for middle aged women where the only growth may be in width but not height, CTX seems to be roughly 8 times the value of P1NP, using only the lowest values or the highest for the calculation. If osteoporosis is being treated, obviously, the steady state would not apply
CTX: 150-635 pg/ml (30-39 years)
P1NP: 19-83 mcg/L (Adult female premenopausal)
My baseline ratio is 4:1. Am I building more bone than losing it (diagnosed with osteoporosis) or are we putting too much emphasis on these values? The answer may be that we should use them simply as a guide or to monitor changes- further decline or the effect of treatment.
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I agree.
The establishment value of CTX is only within the context of prior and post bisphosphonate use. And then it is only used to indicate whether the medication is "working." Even then, it is questionable because we tend to change up diet and exercise and when we get the diagnosis. And if there a fracture is undetected, mild or in the spicule ( I must have strained a muscle), phase all bets are off.
There is a lot of noise about the over-prescribed osteoporosis patient. I often suspect that I'm one of those taking high-powered drugs who never would have fractured anyway.
It seems to me that the goal should be to "maintain a steady state of bone tear-down and bone building" But I don't know how (or if) you can use the ratio of CTX and P1NP.
Thanks for the insight about the growth in width being reflected by an 8 to 1 ratio.
If osteoporosis is being treated wouldn't the steady state be best, but with an increase in the number of couplets of osteoblasts and osteoclasts at least in regard to strength. It can't be just the ratio.
Norma, I've enjoyed this.rather more than a person should. Thanks