Urine
Pyridinoline: Deoxypyridinoline
Measure your bone health with our Pyridinoline (PYD) and Deoxypyridinoline (DPD) urine tests; essential for monitoring bone breakdown and assessing osteoporosis risk.
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Muscles and bones · Urine
Deoxypyridinoline (urine)
Deoxypyridinoline in urine is a measure of the rate of bone breakdown; it is not a test for osteoporosis.
At a glance
- Measured in urine
- In 1 test panel
- Check the preparation
Explanation
Deoxypyridinoline (urine): what is measured?
The analysis measures how much deoxypyridinoline is excreted in the urine. Deoxypyridinoline is a cross-link between collagen fibers that is found almost only in bone and in dentin. These cross-links are released when bone is broken down and leave the body through the urine. This makes deoxypyridinoline more specific for bone than pyridinoline. Bone tissue is broken down and rebuilt throughout life; this marker says something about the rate of breakdown at that moment, not about how much bone there is.
What can it detect?
- An increased rate of bone breakdown at the time of measurement
- A change in that rate during a treatment that slows bone breakdown
Result
What does the result mean?
Deoxypyridinoline (urine) too high
A high value fits an increased rate of bone breakdown. This occurs in the years around and after menopause, with long-term use of prednisone, with an overactive parathyroid gland or thyroid, with long-term bed rest and after a recent bone fracture, after which the value stays raised for weeks to months. A high value does not mean there is osteoporosis and on its own says nothing about the risk of a fracture. In growing children and young people the value is normally high.
Deoxypyridinoline (urine) too low
A low value fits a low rate of bone breakdown. This can be normal, or fit a treatment with a drug that slows bone breakdown. A low value does not mean the bones are strong: the amount of bone is measured with a bone density scan (DXA), not with this marker.
After an abnormal result
With a question about osteoporosis, the GP first estimates the risk of a fracture and, if needed, requests a bone density scan; blood tests are part of this. An abnormal marker value alone does not lead to any set follow-up tests.
Reliability
How reliable is the test?
In an individual person, a single value says little about the amount of bone or about the risk of a fracture. The diagnosis of osteoporosis is made with a bone density scan (DXA); the laboratory tests that the guideline on osteoporosis and fracture prevention mentions alongside it look for an underlying cause and include calcium, albumin, creatinine, TSH and vitamin D in blood. A single urine sample varies strongly with how much you drink and with what you ate the day before. That is why the result is usually corrected for the creatinine level, or urine is collected over 24 hours.
What can affect the result?
- Excretion follows a daily rhythm and is highest in the morning; the time of urinating strongly affects the result.
- After a fracture the value stays raised for weeks to months, without this saying anything about osteoporosis.
- The result varies considerably from day to day, which makes a single measurement hard to interpret.
- There are no agreed cut-off values; laboratories use different methods and reference values.
Preparation
- Collect the urine in the morning, by 9.00 at the latest. The value varies a lot over the day.
Who it is for
Who is the test useful for?
Useful for
The result says the most with unexplained or severe bone abnormalities or when monitoring a treatment that slows bone breakdown, and then in combination with other tests. It is not a test for osteoporosis: in people without symptoms, the result adds nothing to estimating the risk of fracture. If you want to know about that, you need a risk assessment and, if needed, a bone density scan.
How common is it?
Osteoporosis is common, especially in women after menopause and in older people. Osteoporosis is diagnosed with a bone density scan, not with markers in urine.
FMS guideline on osteoporosis and fracture prevention and Thuisarts.nl
Drawbacks and risks
- A high value can wrongly be read as osteoporosis, which leads to worry and unnecessary follow-up tests.
- A low value can give false reassurance, while it does not measure the risk of fracture.
Get tested
Deoxypyridinoline (urine): test panels
Deoxypyridinoline (urine) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results