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Urinary excretion of deoxypyridinoline in Perthes' disease: a prospective, controlled comparative study in 83

B Westhoff1, R Krauspe, A E Kalke

  • 1Department of Orthopaedics, Heinrich-Heine-University, Moorenstrasse 5, D-40225, Dusseldorf, Germany. westhoff@med.uni-duesseldorf.de

The Journal of Bone and Joint Surgery. British Volume
|June 27, 2006
PubMed

Insights

Urinary deoxypyridinoline (DPD) levels are reduced in early Perthes' disease, indicating lower bone turnover. These levels may help monitor the disease

Area of Science:

  • Orthopedics
  • Biochemistry
  • Pediatric Endocrinology

Background:

  • Perthes' disease is a hip disorder affecting children.
  • Bone resorption markers are crucial for understanding bone metabolism in pediatric conditions.
  • Deoxypyridinoline (DPD) is a validated marker for bone resorption.

Purpose of the Study:

  • To investigate the relationship between urinary deoxypyridinoline (DPD) excretion and Perthes' disease.
  • To assess DPD as a potential biomarker for monitoring disease progression and bone turnover in Perthes' disease.

Main Methods:

  • Collected first-morning urine samples from 39 children with active Perthes' disease and 44 healthy controls.
  • Analyzed urinary DPD levels using chemiluminescence immunoassay.
  • Correlated DPD levels with radiological staging (Waldenström, Catterall, Herring) and DPD/creatinine (CREA) ratio.

Main Results:

  • Median urinary DPD/CREA ratio was significantly reduced in the condensation stage of Perthes' disease compared to controls (p < 0.0001).
  • DPD/CREA ratios showed a trend towards elevated values in the final disease stage (p = 0.05).
  • Herring-C patients exhibited significantly lower DPD/CREA ratios than Herring-B patients (p = 0.03).

Conclusions:

  • Significantly decreased urinary DPD/CREA ratios in early Perthes' disease suggest reduced bone turnover.
  • Findings support a potential systemic etiology for Perthes' disease.
  • Urinary DPD levels may serve as a valuable tool for monitoring the course of Perthes' disease.

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