Hydroxyproline, urinary excretion

Goulding, A., Chesner, R. Comparison of effects of parathyroidectomy and ethane-l-hydroxy-1, 1-diphosphonate (EHDP) administration upon bone synthesis of hydroxyproline and urinary excretion of hydroxyproline in rats. Calc. Tiss. Res. 23, 115 (1977)... 

A 2-year randomized controlled study in 90 women compared the effects of oral tibolone doses of 1.25 mg/day and 2.5 mg/day on bone loss in the early postmenopausal period all took calcium 1000 mg/day. Vertebral and femoral bone density rose in both treated groups but fell in the control group, and bone turnover markers (urinary excretion of hydroxyproline/creatinine and plasma osteocalcin concentrations) were similarly affected favorably in the treated groups, as was the incidence of hot flushes/ flashes (5). Studies such as this still leave open the question of the advisability of continuing tibolone treatment over a longer period. While tibolone has indeed been shown to benefit mineral bone density, few data are available to show whether it lowers fracture incidence nor is it clear whether there is a link between tibolone and breast cancer (6). 

Vitamin C status is generally assessed by estimating the saturation of body reserves or measuring plasma and leukocyte concentrations of the vitamin. Urinary excretion of hydroxyproline-containing peptides is reduced in people with inadequate vitamin C status, but a number of other factors that affect bone and connective tissue turnover confound interpretation of the results (Bates, 1977). The ratio of deoxypyridinolineipyridinoline compounds derived from collagen cross-links provides a more useful index, but is potentially affected by copper status (Tsuchiya and Bates, 1997). 

Urine volume increases during pregnancy so that it is typically 25% greater in the third trimester than in the non-pregnant woman. The glomerular filtration rate increases by 50% during the third trimester. This results in increased urinary excretion of hydroxyproline and increased creatinine clearance. 

Kohler and Pechet (K4) studied the changes in the urinary excretion of calcium, phosphorus, magnesium, °Sr, and hydroxyproline in intact and thyroparathyroidectomized rats in which the bones had previously... 

B20. Brunish, R., and Sorensen, B., Urinary excretion of acid mucopolysaccharides and hydroxyproline in psoriasis. Dermatologica 130, 165-172 (1965). 

F13. Frey, J., The value of the determination of senun hydroxyproline and urinary excretion hydroxyproline in the study of disturbances of collagen metabolism. J. Med. Lyon 46, 1547-1556 (1964). 

Rodnan, G. P., and Cammarata, R. J., Urinary excretion of hydroxyproline in progressive systemic sclerosis (diffuse scleroderma). Arthritis Rheumat. 6, 294 (1963) (abstr.). 

Goulding A and Lim PE (1983) Effects of varying dietary salt intake on the fasting urinary excretion of sodium, calcium and hydroxyproline in young women. N Z Med J 96 853 —854. 

Urinary excretion of uric acid, oxalic acid, calcium, phosphate, hydroxyproline and cAMP was higher in patients with renal stones than that observed in patients without nephrolithiasis, but the difference was not statistically significant. 

Moreover, PPP(H) administration to hypophysectomized immature male rats has been shown to Increase the urinary excretion of hy-droxyproline (C Breuer, personal communication) Hydroxyproline was measured by a modification of the method of Neuman and Logan (20) a consistent 2-3 fold increase in 24 hr excretion over that of controls has been observed in rats receiving 5-12 mg of PPP(H)/day for periods of 4-14 days. 

Schoeninger, M.J. and DeNiro, M.J. 1984 Nitrogen and carbon isotopic composition of bone collagen from marine and terrestrial animals. Geochimica et Cosmochimica Acta 48 625-639. Schuette, S. A., Hegsted, M., Zemel, B. and Linkswiler, H.M. 1981 Renal acid, urinary cyclic AMP, and hydroxyproline excretion as affected by level of protein, sulfur amino acids and phosphorus intake. Journal of Nutrition 111 2106-2116. 

D2. Deacon, A. L., Hulme, P., Hesp, R., Green, J. R., Teller, M., and Reeve, J., Estimation of whole body bone resorption rate A comparison of urinary total hydroxyproline excretion with two radioisotopic tracer methods in osteoporosis. Clin. Chim. Acta 166, 297-306... 

The first aspect has been overcome by measurement of urinary hydroxyproline in individuals with an inherited deficiency of hydroxyproline oxidase. Such persons excrete... 

Calcitonin is a useful marker for medullary carcinoma of the thyroid, which occurs both sporadically and as a dominantly inherited disease. In this type of tumor, the plasma concentration of calcitonin is 1-1000 mg/mL (normal concentration ranges from undetectable to 0.05 ng/mL). Also, urinary hydroxyproline excretion is decreased. Ectopic secretion of calcitonin also occurs from several types of pulmonary tumor in addition to other hormones. 

In several published studies of urinary hydroxyproline excretion in normal adult subjects, males were noted to excrete larger quantities of total hydroxyproline (Table 2). When absolute hydroxyproline excretion was corrected for either surface area or creatinine excretion, no differences between males and females were noted. This observation suggests that... 

The age of the subject is a major factor in the interpretation of urinary hydroxyproline levels (S15). Measurements in subjects during active growth have shown elevations to 15-fold the normal adult level (J9). For this reason, it would seem reasonable to divide subjects under the age of 25 into several groups, each requiring its own growth rate -matched controls. Also, more variability is observed in the urinary hydroxyproline levels of these younger subjects than in those of adults. Consequently, attempts have been made to correct the actual hydroxyproline excretion for some parameter of size, such as body surface area. Table 3 outlines the published normal urinary hydroxyproline levels in infants, children, adolescents, and young adults. Both uncorrected and corrected data are... 

Children 1-10 years). There is large variation in normals in this age group, perhaps because of the variable growth rates in children and the early age at which females begin the prepubertal growth spurt. When the data are separately presented, normal female children have a higher urinary hydroxyproline excretion than males of comparable age (Table 2). 

Adults 24 years or older). The normal adult level of urinary hydroxyproline is fairly well defined, as shown in Table 2. In 32 studies surveyed, reporting data from 515 normal subjects, 25 studies found no normal adults excreting more than 50 mg/day three studies, no more than 60 mg (A2, B6, L7) three studies, no more than 70 mg (J8, L8, R2) and one study, no more than 90 mg (B20). If three subjects were eliminated from this large group, all normal values would be less than 70 mg/day. In the author s experience, the upper limit of normal urinary hydroxyproline excretion, in adults of age 25 or older on diets free of meat... 

The wide variation in normal urinary hydroxyproline levels in children has been discussed above. The most consistent of the abnormalities of urinary hydroxyproline in children, as shown in Table 4, is the decreased excretion associated with defective growth. Whether the cause of growth retardation is hormonal, genetic, or environmental (malnutrition or chronic disease and/or drug therapy), urinary hydroxyproline excretion is decreased. When the hydroxyproline excretion is corrected for surface area or creatinine excretion, this measurement seems to correlate well with the extent of growth retardation (W4). In spite of the fact that creatinine excretion is also reduced in malnutrition, Whitehead found an... 

Anderson, J., Bannister, D. W., and Tomlinson, R. W. S., Total urinary hydroxyproline excretion in normal human subjects. Clin. Sci. 29, 583-587 (1965). 

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