Evaluation of bone disease in multiple myeloma: a comparison between the resorption markers urinary deoxypyridinoline creatinine (DPD) and serum ICTP, and an evaluation of the DPD osteocalcin and ICTP osteocalcin ratios

Markers of bone metabolism were measured in 73 newly diagnosed myeloma pati ents and in age-matched controls. Correlations to bone disease on X-rays an d survival were performed. In urine deoxypyridinoline/creatinine (DPD) and in serum carboxyterminal pyridinoline cross-linked telopeptide of type I co llagen (ICTP), procollagen type I carboxy-terminal extension peptide (PICP) and osteocalcin were analyzed. The ratios DPD/osteocalcin and ICTP/osteoca lcin were calculated. Skeletal X-ray findings were divided into no, limited and extensive bone involvement. DPD and ICTP levels were significantly ele vated in patients compared to controls. Levels increased with advancing ske letal involvement. Serum osteocalcin was elevated in patients without visib le bone disease. The level decreased with more advanced bone involvement. T he finding of significantly elevated osteocalcin and ICTP levels in patient s without bone involvement on X-rays indicates that bone markers might refl ect bone disease better than X-rays in untreated myeloma patients. Ratios b etween bone resorption and bone formation markers added no further informat ion on bone disease or survival. Only ICTP had prognostic value with an inv erse correlation between serum levels and survival.