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.
€ 60,00
All tests
Muscles and bones · Urine
Pyridinoline (urine)
Pyridinoline 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
Pyridinoline (urine): what is measured?
The test measures how much pyridinoline is excreted in the urine. Pyridinoline is a cross-link between collagen fibers. These links are released when collagen is broken down and leave the body through the urine. Pyridinoline is found not only in bone, but also in cartilage, tendons and blood vessel walls; the result therefore does not come only from bone. 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 inhibits bone breakdown
Result
What does the result mean?
Pyridinoline (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 or thyroid gland, with prolonged bed rest and after a recent fracture, after which the value stays raised for weeks to months. A high value does not mean there is osteoporosis and in itself says nothing about the risk of a fracture. In growing children and young people, the value is normally high.
Pyridinoline (urine) too low
A low value fits a low rate of bone breakdown. This can be normal, or fit treatment with a medicine that inhibits 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 orders a bone density scan if needed; this comes with laboratory tests in blood. An abnormal marker value on its own does not lead to any set follow-up tests.
Reliability
How reliable is the test?
In one person, a single value says little about the amount of bone or the risk of a fracture. Osteoporosis is diagnosed with a bone density scan (DXA); the laboratory tests that the guideline on osteoporosis and fracture prevention mentions for this look for an underlying cause and include calcium, albumin, creatinine, TSH and vitamin D in blood. A single urine sample varies greatly 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 urination 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 is mainly meaningful with unexplained or severe bone abnormalities or when following a treatment that inhibits 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 fracture risk. 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 further tests.
- A low value can give false reassurance, while it does not measure the fracture risk.
Get tested
Pyridinoline (urine): test panels
Pyridinoline (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 resultsMore explanations