What are the expected serum levels of C-telopeptides (CTx) in a 75-year-old male?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

For a 75-year-old male, the expected levels of C-telopeptides (CTX) in serum can vary, but generally, elevated levels above 0.5 ng/mL may indicate increased bone resorption 1.

Reference Ranges

The following reference ranges should be considered:

  • Normal range: 0.1-0.5 ng/mL
  • Elevated range: above 0.5 ng/mL, which may require further evaluation and potential treatment with medications such as bisphosphonates (e.g., alendronate 70 mg weekly or risedronate 35 mg weekly) to reduce bone resorption 1. It's essential to interpret these levels in the context of the patient's overall clinical picture, including medical history, physical examination, and other diagnostic tests, such as bone mineral density (BMD) measurements.

Key Points to Consider

  • Serum type 1 collagen C-terminal telopeptides (CTx) have been identified as sensitive predictors of bone metastases in patients with advanced tumors 1.
  • Elevated levels of CTx have been linked to increased risk of skeletal-related events (SREs), disease progression, and death 1.
  • The use of bone markers, including CTx, to guide treatment decisions is still being investigated, and more research is needed to determine their clinical utility 1.

Important Considerations

  • The patient's medical history, physical examination, and other diagnostic tests should be taken into account when interpreting CTx levels 1.
  • Bisphosphonates, such as alendronate or risedronate, may be considered to reduce bone resorption in patients with elevated CTx levels 1.

From the Research

Serum C-telopeptides (CTx) Levels

The expected serum levels of C-telopeptides (CTx) in a 75-year-old male are not directly stated in the provided studies. However, the studies provide information on the levels of CTx in different populations and conditions:

  • A study on hemodialysis patients found that the mean age of the patients was 59.7 years, and the serum beta-CTx levels correlated significantly with bone resorption markers and bone mineral density 2.
  • A study on patients with hip osteoarthritis found that urinary CTX-II levels were higher in patients with rapidly destructive hip osteoarthritis than in those with slowly progressive hip osteoarthritis, but it did not provide information on serum CTx levels in healthy individuals 3, 4.
  • A study on cancer patients with bone metastases found that the mean age of the patients was 69 years, and the mean serum CTx levels at baseline were 562.47 ± 305.17 pg/dl 5.
  • A study on the acute responses of serum type I collagen telopeptides to repeated ingestion of calcium found that serum CTx levels decreased by 38.7% to 61.0% after ingestion of calcium-fortified water, but it did not provide information on the expected serum levels of CTx in healthy individuals 6.

Factors Affecting CTx Levels

Several factors can affect CTx levels, including:

  • Bone resorption: CTx levels are a marker of bone resorption, and high levels may indicate increased bone resorption 2, 6.
  • Age: CTx levels may increase with age, but the studies did not provide a clear correlation between age and CTx levels 2, 5.
  • Calcium intake: Calcium intake can affect CTx levels, with high calcium intake leading to decreased CTx levels 6.
  • Disease status: CTx levels may be affected by disease status, such as bone metastases or osteoarthritis, with higher levels indicating more severe disease 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Serum levels of C-terminal telopeptide of type I collagen: a useful new marker of cortical bone loss in hemodialysis patients.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2005

Research

Serum C-telopeptide levels predict the incidence of skeletal-related events in cancer patients with secondary bone metastases.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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