Blutwerte · Marker

CTX

C-terminal Telopeptide · Beta-CrossLaps · CTX · Bone Resorption Marker

Knochen & MineralogieNüchtern erforderlichZeitabhängig

Einheit:: ng/mL
Abbreviation: CTX / b-CTX

CTX quantifies the rate of bone resorption by measuring the concentration of C-terminal telopeptide fragments of type I collagen in the blood.

Reference Ranges

Reference

0.1–0.6ng/mL

0.1

0.6

LowNormalHigh

Reference

Unit · ng/mL

Levels can vary based on age, sex, and renal function. Fasting morning samples are recommended.

Overview

Übersicht

C-terminal telopeptide (CTX), also known as Beta-CrossLaps, is a biochemical marker of bone resorption. It is a fragment released into the bloodstream during the breakdown of type I collagen, a major component of bone. Researchers have found that CTX levels reflect the rate of bone turnover and are used to assess bone health, particularly in conditions like osteoporosis. Clinically, CTX is significant in evaluating fracture risk and monitoring the effectiveness of osteoporosis treatments. Elevated CTX levels are associated with increased bone resorption, which can indicate heightened fracture risk, especially in postmenopausal women. In the context of athletic performance and biohacking, CTX may be used to monitor bone health and the impact of physical activity on bone turnover. However, its utility in these areas is less established compared to its clinical use in osteoporosis. Caveats include potential confounders such as renal function, as CTX levels may be elevated in chronic kidney disease due to impaired clearance. Additionally, CTX levels exhibit diurnal variation, with higher levels in the early morning, necessitating standardized timing for sample collection, typically in a fasting state, to ensure comparability.

Klinische Bedeutung
Elevated CTX levels indicate increased bone resorption, which is associated with a higher risk of fractures and osteoporosis. Reduced CTX levels may suggest effective treatment of osteoporosis or low bone turnover.

Dynamics

Trend Interpretation

Rising Values

Rising CTX levels suggest increased bone resorption, potentially indicating worsening osteoporosis. Re-test in 3-6 months to assess treatment efficacy.

Falling Values

Falling CTX levels may indicate effective treatment of osteoporosis or reduced bone turnover.

Re-test Interval

3-6 months if outside optimal range

Etiology

Causes — High & Low

Cause

Elevated Levels

Osteoporosis
Hyperparathyroidism
Paget's disease
Chronic kidney disease
Prolonged immobilization

Cause

Low Levels

Effective osteoporosis treatment
Low bone turnover
Hypoparathyroidism
Use of antiresorptive medications

Protocol

How to Optimize

Lever

Lifestyle

Weight-bearing exercise
Smoking cessation
Moderate alcohol consumption

Lever

Nutrition

Adequate calcium intake
Vitamin D-rich foods

Lever

Supplementation

Calcium
Vitamin D

Note:

Consult a healthcare provider before starting any supplementation, especially if on medication for bone health.

Testing Guidelines

🍽️Fasting Required

🕐Time-Sensitive

CTX levels peak in the early morning; fasting morning samples are recommended for consistency.

Testing Frequency

Annually for osteoporosis monitoring, more frequently if adjusting treatment.

Interfering Factors

Recent intense exercise
Renal impairment

Related Peptides & Hormones

Parathyroid Hormone

Correlated with

hormone

Open Research Questions

Current research suggests that the interaction of β-CTX-I with other fracture risk factors remains insufficiently studied, limiting its incorporation into fracture risk algorithms. Researchers have not yet established optimal reference ranges for β-CTX-I in patients with advanced chronic kidney disease, where confounding factors may elevate levels. Additionally, clinical questions remain regarding the precise role of β-CTX-I in monitoring treatment responses and its predictive value for long-term outcomes in osteoporosis management.

50 Research Publications

2,249

Total Citations

Human/RCT

7.8

Avg. Influence

2023

Latest

Sort

Filter

01Top

#01

Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards.

ReviewInfluence64.0

1139

This study highlighted the importance of bone turnover markers (BTMs) in predicting fracture risk and monitoring osteoporosis treatment. Researchers found that high levels of BTMs can predict fracture risk independently of bone mineral density. They also emphasized the need for international reference standards for BTMs to enhance clinical practice.

View on PubMed

02Top

#02

The spread of CTX-M-type extended-spectrum beta-lactamases.

ReviewInfluence13.0

194

Researchers examined the rapid global spread of CTX-M-type extended-spectrum beta-lactamases among Enterobacteriaceae. They found that these enzymes are now the most prevalent in certain areas, impacting antibiotic treatment strategies. The study highlights the importance of understanding the epidemiology of these enzymes for effective laboratory detection.

View on PubMed

03Top

#03

Osteoarthritis Year in Review 2016: biomarkers (biochemical markers).

Mobasheri A, et al. · Osteoarthritis and cartilage · 2017

ReviewInfluence3.0

160

This review summarized advancements in biomarker research related to osteoarthritis. Researchers noted the identification of new biomarkers and the development of novel technologies for measuring existing ones. However, they highlighted ongoing challenges in discovering early biomarkers for osteoarthritis.

Key findings

01Researchers observed the identification of new biomarkers like ADAMTS-4 and CCL3 for knee osteoarthritis.
02They noted advancements in measurement technologies, including a novel magnetic nanoparticle-based method.
03Researchers highlighted the publication of new guidelines for using biomarkers in clinical trials, which could enhance future studies.

View on PubMed

#04

Calcium and Bone Metabolism Indices.

ReviewInfluence5.0

128

Researchers observed that calcium and phosphate homeostasis is tightly regulated, with bone turnover markers like serum N-terminal propeptide of type I procollagen (P1NP) and C-terminal telopeptide (CTX) potentially useful for predicting fracture risk. The study calls for standardization of sample collection protocols to improve the clinical utility of these markers.

View on PubMed

#05

Diagnosis, treatment, and clinical outcomes in 43 cases with cerebrotendinous xanthomatosis.

Case ReportInfluence6.0

107

This study reviewed clinical outcomes in patients with cerebrotendinous xanthomatosis (CTX). Researchers found that treatment with CDCA significantly reduced plasma cholestanol levels and improved symptoms in a majority of patients. The study emphasized the need for awareness of CTX in young patients with specific clinical features.

View on PubMed

#06

Treatment With Zoledronate Subsequent to Denosumab in Osteoporosis: A 2-Year Randomized Study.

HumanInfluence8.0

Researchers investigated the effects of zoledronate treatment after discontinuing denosumab in osteoporosis patients. They found that while bone mineral density was maintained over two years, significant bone loss occurred in all groups, indicating the need for ongoing monitoring of bone turnover markers like p-CTX.

View on PubMed

#07

Rapid emergence of extensively drug-resistant Shigella sonnei in France.

HumanInfluence3.0

This study reported on the rapid emergence of extensively drug-resistant Shigella sonnei in France. Researchers documented the increasing resistance to multiple antibiotics and highlighted the importance of laboratory surveillance for effective public health responses. The findings raise concerns about the implications of these resistant strains on treatment options.

View on PubMed

#08

An update on biomarkers in axial spondyloarthritis.

Prajzlerová Klára, et al. · Autoimmunity reviews · 2016

ReviewInfluence1.0

Researchers found that while HLA-B27 is the best genetic biomarker for axial spondyloarthritis diagnosis, circulating biomarkers like CRP are useful for assessing disease activity. Other biomarkers, including CTX-II, may predict spinal structural progression, although their effectiveness needs further validation in larger studies.

Key findings

01HLA-B27 is currently the best genetic biomarker for diagnosing axial spondyloarthritis.
02CRP is the most effective circulating measure for assessing disease activity and predicting progression.
03New biomarkers, such as calprotectin, may help monitor therapeutic responses but require further validation.

View on PubMed

#09

The evolving role of biomarkers for osteoarthritis.

ReviewInfluence1.0

This review highlights the urgent need for effective biomarkers in osteoarthritis (OA) diagnosis and monitoring. Researchers emphasize that structural molecules and fragments from bone and cartilage could serve as potential biomarkers, aiding in the early detection and treatment of OA.

View on PubMed

#10

Tumor monocyte content predicts immunochemotherapy outcomes in esophageal adenocarcinoma.

HumanInfluence4.0

In a trial involving patients with inoperable esophageal adenocarcinoma, researchers identified high tumor monocyte content as a predictor of better overall survival following immunochemotherapy. They also noted that tumor mutational burden could serve as an additional predictor, aiding in patient selection for treatment.

201

Started

2006

Primary outcome

Urinary excretion of CTX-II at 3 and 6 months post intervention

Osteoarthritis

Dose-Response of Gonadal Steroids and Bone Turnover in Older Men

NCT00114114COMPLETED

Sponsor

Massachusetts General Hospital

Enrollment

177

Started

2004

Primary outcome

Percent Change in Bone Turnover Marker (Serum C-telopeptide, CTX)

Healthy Volunteers

Publication Trend

Research publications about CTX over time

9total

'12

'13

'14

'16

'20

'21

'23

Track your bloodwork in PepStack

Log lab results, track trends and optimize your biomarkers over time.

Download on theApp Store Get it onGoogle Play

Legal Disclaimer

This page is for informational and research purposes only. All information is based on published scientific literature and does not constitute medical advice, diagnosis, or treatment recommendations. Many substances listed may not be approved for human use and may be subject to drug regulation laws (e.g., AMG in Germany, FDA in the US). PepStack does not encourage the use of any substance on humans. Always consult a qualified healthcare professional before making any health-related decisions. Use of this information is entirely at your own risk. PepStack assumes no liability for the accuracy, completeness, or timeliness of the content provided. Full disclaimer