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Lifestyle
- Regular weight-bearing exercise
- Adequate sun exposure
- Smoking cessation
Blutwerte · Marker
P1NP
Procollagen Type I N-Terminal Propeptide · PINP
Knochen & MineralogieZeitabhängig
- Einheit:
- ng/mL
P1NP quantifies the synthesis of type I collagen, indicating bone formation rates.
Reference Ranges
Age Group
Reference
20–90ng/mL
20
60
90
LowNormalHigh
Reference
Optimal
Unit · ng/mLLevels vary by age and sex; higher in children and adolescents due to growth.
Overview
Übersicht
Procollagen Type I N-Terminal Propeptide (P1NP) is a biomarker that reflects the synthesis of type I collagen, the predominant collagen in bone. It is released into the bloodstream during the formation of new bone matrix, making it a useful indicator of bone formation rates. Clinically, P1NP is significant in the diagnosis and management of osteoporosis, as elevated levels can indicate high bone turnover, which is associated with increased fracture risk. It is also used to monitor the effectiveness of osteoporosis treatments, as changes in P1NP levels can reflect treatment response. In the context of athletic performance, P1NP can provide insights into bone health, particularly in athletes at risk of bone stress injuries due to conditions like Relative Energy Deficiency in Sport (REDs). Monitoring P1NP can help in assessing bone formation and the risk of stress fractures. However, P1NP levels can be influenced by factors such as renal function, circadian rhythms, and nutritional status. Researchers recommend standardized sample collection protocols to minimize variability and improve the reliability of P1NP measurements.
Klinische Bedeutung
Elevated P1NP levels suggest increased bone turnover, often seen in osteoporosis or metabolic bone diseases. Reduced levels may indicate suppressed bone formation, potentially due to nutritional deficiencies or hormonal imbalances.
Dynamics
Trend Interpretation
Rising Values
Rising P1NP values suggest increased bone turnover, possibly due to osteoporosis or fracture healing. Re-test in 3-6 months.
Falling Values
Falling P1NP values may indicate effective treatment response or reduced bone formation.
Re-test Interval
6 months if outside optimal range
Etiology
Causes — High & Low
Cause
Elevated Levels
- Osteoporosis
- Paget's disease
- Hyperparathyroidism
- Fracture healing
- Bone metastases
Cause
Low Levels
- Nutritional deficiencies
- Hormonal imbalances
- Chronic kidney disease
- Hypoparathyroidism
- Prolonged corticosteroid use
Protocol
How to Optimize
Lever
Nutrition
- Calcium-rich foods
- Vitamin D supplementation
- Balanced diet with sufficient protein
Lever
Supplementation
- Vitamin D
- Calcium
- Magnesium
Note:
Consult a healthcare provider before starting any supplementation, especially if you have underlying health conditions.
Testing Guidelines
✓Fasting Not Required
🕐Time-Sensitive
Draw samples at the same time of day due to circadian variations.
Testing Frequency
Every 6-12 months for osteoporosis management.
Interfering Factors
- Recent intense exercise
- Renal impairment
- Nutritional status
Related Peptides & Hormones
Parathyroid Hormone
hormoneMay affect
Open Research Questions
Current research suggests that reference ranges for P1NP may vary significantly by age, sex, and ethnicity, particularly in pediatric populations, indicating a need for standardized protocols. Researchers have not yet established optimal target levels for P1NP in various clinical contexts, such as chronic kidney disease or relative energy deficiency in sport. Additionally, the interaction of P1NP with other risk factors in fracture risk algorithms remains inadequately explored, leaving clinical implications uncertain.
55 Research Publications
1,864
Total Citations
28
Human/RCT
9.5
Avg. Influence
2024
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.
ReviewInfluence69.0
1161
Researchers found that P1NP and CTX are recommended as reference markers for assessing bone turnover and predicting fracture risk in osteoporosis. The study highlighted the need for international standards to enhance the reliability of these biomarkers in clinical practice. It also noted that treatment-induced changes in these markers are significant for monitoring therapy effectiveness.
02Top
#02
Intravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate.
HumanInfluence8.0
187
This study examined the effects of a single intravenous infusion of zoledronic acid compared to weekly oral alendronate in postmenopausal women with low bone density. Researchers found that the infusion maintained bone mineral density for 12 months and that patients preferred the yearly infusion over weekly oral therapy. Additionally, biomarkers related to bone turnover showed different patterns between the two treatment groups.
03Top
#03
Calcium and Bone Metabolism Indices.
ReviewInfluence5.0
130
Researchers found that bone turnover markers, including P1NP, can predict fracture risk and monitor responses to osteoporosis treatments. The study emphasized the need for standardized protocols for measuring these markers due to their variability. It also discussed the critical roles of calcium and phosphate in bone metabolism.
04
#04
Development of a highly sensitive, high-throughput, mass spectrometry-based assay for rat procollagen type-I N-terminal propeptide (PINP) to measure bone formation activity.
Animal
34
Researchers developed a highly sensitive mass spectrometry-based assay for measuring rat P1NP levels to study bone formation. The study demonstrated that this new assay could effectively monitor changes in P1NP levels in response to treatments affecting bone metabolism. The findings indicate its potential utility in preclinical bone research.
05
#05
Biomarkers for Prostate Cancer Bone Metastasis Detection and Prediction.
ReviewInfluence4.0
31
Researchers reviewed the role of biomarkers, including PINP, in detecting bone metastasis in prostate cancer. They highlighted the limitations of traditional diagnostic methods and the potential of biomarkers to improve early detection and management of bone metastases.
06
#06
Lower serum P1NP/βCTX ratio and hypoalbuminemia are independently associated with osteoporotic nonvertebral fractures in older adults.
Human
31
Researchers observed that a lower serum P1NP/βCTX ratio and hypoalbuminemia are independently associated with an increased prevalence of nonvertebral fractures in older adults. The study indicated that these markers could serve as useful prognostic tools for fracture risk stratification in the elderly population.
07
#07
A multicenter study to evaluate harmonization of assays for N-terminal propeptide of type I procollagen (PINP): a report from the IFCC-IOF Joint Committee for Bone Metabolism.
HumanInfluence3.0
30
This multicenter study evaluated the harmonization of assays for measuring P1NP in clinical laboratories. Researchers found that both serum and plasma samples are suitable for P1NP determination, and they identified significant biases between different assay methods. The study concluded that harmonization efforts could improve the reliability of P1NP measurements across laboratories.
08
#08
Serum Procollagen Type I N-Terminal Propeptide and Osteocalcin Levels in Korean Children and Adolescents.
HumanInfluence1.0
27
This study established reference levels for P1NP and osteocalcin in healthy Korean children and adolescents. Researchers observed significant age- and sex-related variations in P1NP levels, with the highest levels occurring in infancy. The findings indicate the necessity of age-specific reference data for pediatric bone health assessments.
09
#09
Bone Turnover Markers in Children: From Laboratory Challenges to Clinical Interpretation.
ReviewInfluence2.0
24
Researchers found that bone turnover markers (BTMs) in children and adolescents differ from adults due to growth and remodeling processes. This study highlighted the limited clinical use of BTMs in pediatrics due to age- and gender-specific challenges. It also discussed the physiological and pathological modifications of BTMs in younger populations.
10
#10
Broad application prospects of bone turnover markers in pediatrics.
Review
21
Researchers highlighted the challenges and potential of using bone turnover markers (BTMs) in pediatric clinical settings. The study emphasized that BTMs can provide valuable insights into bone development and metabolic disorders in children. It called for more research to establish reliable reference intervals for BTMs in pediatric populations.
Clinical Trials (22)
22
Total Trials
1,585
Total Enrolled
High-Intensity Laser Therapy and Physiotherapy for Bone Health in Postmenopausal Women: A Randomized Trial
NCT07734922NOT_YET_RECRUITING
Sponsor
Iuliu Hatieganu University of Medicine and Pharmacy
Enrollment
40
Started
2026
Primary outcome
Change from baseline in serum procollagen type I N-terminal propeptide (P1NP)
Osteoporosis, PostmenopausalOsteopenia
Effect of Bee Venom on Chronic Kidney Disease-Mineral Bone Disorders in Hemodialysis Patients: a Randomized Controlled Trial
Sponsor
Mansoura University
Enrollment
60
Started
2025
Primary outcome
Improvement in Bone-Specific Biomarkers (BALP, P1NP, TRAP-5b)
Chronic Kidney DiseaseBee VenomHemodialysis
SHORT-term Effects of GLucagon-like Peptide One on BonE
NCT06722560COMPLETED
Sponsor
Odense University Hospital
Enrollment
12
Started
2025
Primary outcome
Change in serum bone formation marker P1NP
To Investigate the Physiological Effect of GLP-1 on the SkeletonHealthy Volunteer
Everolimus and/or Exercise to Prevent Bone Loss in Postmenopausal Women
Sponsor
Odense University Hospital
Enrollment
136
Started
2024
Primary outcome
Procollagen type 1 N-terminal propeptide (P1NP)
Postmenopausal Women
The Effect of Oral Semaglutide on Bone Turnover in Patients With T2D: a Randomized Placebo-controlled Clinical Trial
Sponsor
Odense University Hospital
Enrollment
64
Started
2024
Primary outcome
Procollagen type 1 N-terminal propeptide (P1NP)
Type 2 DiabetesOsteopenia
A Study of Romosozumab in Women With Multiple Myeloma and Osteoporosis
Sponsor
Memorial Sloan Kettering Cancer Center
Enrollment
10
Started
2023
Primary outcome
Percent change in bone formation marker, P1NP
OsteoporosisMultiple Myeloma
The Effect of Aerobic Exercise on Bone Turnover Markers in Postmenopausal Patients
NCT06866561COMPLETED
Sponsor
Bursa Yuksek Ihtisas Training and Research Hospital
Enrollment
45
Started
2022
Primary outcome
The serum levef of Procollagen type 1 N-terminal propeptide (P1NP) (ng/ml)
Postmenopausal Osteopenia
Skeletal Response to Simulated Night Shift
NCT05074277COMPLETED
Sponsor
University of Colorado, Denver
Enrollment
20
Started
2022
Primary outcome
Difference in change in propeptide of type 1 procollagen (P1NP)
OsteoporosisCircadian Rhythm Sleep Disorder, Shift Work Type
Skeletal Effects of Chronic Night Shift
NCT05091021COMPLETED
Sponsor
University of Colorado, Denver
Enrollment
59
Started
2021
Primary outcome
Difference in change of propeptide of type 1 procollagen (P1NP) over 1 year
OsteoporosisCircadian Rhythm Sleep Disorder, Shift Work Type
The Effect of Semaglutide on Bone Turnover in Patients With Increased Risk of Bone Fracture
Sponsor
Morten Frost
Enrollment
64
Started
2021
Primary outcome
Procollagen type 1 N-terminal propeptide (P1NP)
Osteopenia
Denosumab and Osteoporotic Vertebral Compression Fracture
Sponsor
Shenzhen People's Hospital
Enrollment
90
Started
2020
Primary outcome
Procollagen type 1 n-terminal propeptide (P1NP)
Osteoporotic Vertebral Compression Fracture
Advanced Glycation Endproducts and Bone Material Strength in T2D Treated With Pyridoxamine
NCT03778580COMPLETED
Sponsor
Columbia University
Enrollment
55
Started
2018
Primary outcome
Bone formation in serum by P1NP
Diabetes Mellitus, Type 2
Effect of Calcium and Vitamin D Supplementation With and Without Collagen Peptides in Postmenopausal Women With Osteopenia
NCT03999775COMPLETED
Sponsor
Ioannis K. Triantafyllopoulos, MD,MSci,PhD
Enrollment
51
Started
2017
Primary outcome
Comparison of %-changes of P1NP and CTX levels from baseline to 3 months of supplementation between the two groups.
OsteopeniaPostmenopausal Osteopenia
Effect of Vitamin D Supplementation on Bone Turnover Markers During PrEP in MSM
Sponsor
University of California, San Diego
Enrollment
48
Started
2014
Primary outcome
Change in Total Procollagen Type 1 N-terminal Propeptide (a Marker of Bone Formation) [P1NP] Levels
Patient Adherence
Roflumilast on Markers of Bone Metabolism and Endothelial Function in COPD
Sponsor
University of Pittsburgh
Enrollment
26
Started
2013
Primary outcome
Change From Baseline of Systemic Markers of Bone Metabolism (C-terminal Peptide of Type 1 Collagen (CTx) and Amino-terminal Propeptide of Type-1 Procollagen (P1NP))
Chronic Obstructive Pulmonary Disease
Vibration in Boys With a History of Fracture
NCT04241432COMPLETED
Sponsor
Sheffield Children's NHS Foundation Trust
Enrollment
20
Started
2012
Primary outcome
Serum bone turnover marker concentrations: P1NP and CTX (ng/ml)
Fracture
Effect of Dexlansoprazole on Bone Homeostasis
Sponsor
Takeda
Enrollment
115
Started
2010
Primary outcome
Percent Change From Baseline to Week 26 in Bone Formation Marker Aminoterminal Propeptide of Type 1 Collagen (P1NP)
HomeostasisBone and Bones
African-American Bone Metabolism and Lactation Study
NCT00785824COMPLETED
Sponsor
University of Pittsburgh
Enrollment
58
Started
2009
Primary outcome
Measurements of amino-terminal telopeptides of procollagen 1 (P1NP), a marker of bone formation, in lactating and non-lactating post-partum African-American women both at 6-8 and at 12-14 weeks post-partum and normal controls
LactationBone Diseases, Endocrine
Efficacy & Safety of ViaDerm-hPTH(1-34) Compared to Forteo SC in Postmenopausal Women With Osteoporosis
Sponsor
TransPharma Medical
Enrollment
104
Started
2008
Primary outcome
Change from baseline to endpoint 96 days in procollagen 1 N-terminal propeptide (P1NP)
Osteoporosis
Effects of Hesperidin on Bone Biomarkers in Postmenopausal Women
Sponsor
Société des Produits Nestlé (SPN)
Enrollment
144
Started
2007
Primary outcome
Percentage change from baseline for bone formation (serum P1NP & osteocalcin) and bone resorption (urinary NTX & serum CTX) markers
OsteopeniaOsteoporosis
OPTAMISE: Clinical Effectiveness of Teriparatide After Alendronate or Risedronate Therapy in Osteoporotic Postmenopausal Women
Sponsor
Sanofi
Enrollment
290
Started
2004
Primary outcome
Compare the PTH-associated change from baseline at Month 3 of procollagen peptide P1NP, in subjects previously treated with Risedronate or Alendronate
Osteoporosis, Postmenopausal
Magnesium Supplementation to Prevent Bone Loss
Sponsor
University of Tennessee
Enrollment
74
Started
2002
Primary outcome
Biomarkers bone turnover (P1NP and CTX)
Osteoporosis
Publication Trend
Research publications about P1NP over time
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