The chronic pain that manifests in the tender points of the body in fibromyalgia often occurs near bone and connective tissue joints. This has led some researchers to investigate the possible role of abnormalities in bone and connective tissue mechanisms in this chronic condition. Interesting evidence has recently emerged from work exploring the role of two important collagen crosslinks excreted in urine, markers of bone resorption.

Pyridinoline (Pyd) is an indicator of connective tissue disease; deoxypyridininium (D-pyd) is an indicator of bone degradation. Higher levels of D-pyd are associated with a rapid rate of bone tissue breakdown and thus a higher risk of osteoporosis.

A case-control study of 39 patients with fibromyalgia diagnosed using American College of Rheumatology criteria found that Pyd/D-pyd ratios in the urine and were significantly lower in patients with fibromyalgia than in 55 age-matched healthy controls.1,2

The researchers suggested that decreased levels of urinary collagen crosslinks could play an important in the development of fibromyalgia, with lower levels possibly indicating a propensity for excess collagen deposits to form around nerve fibers, eventually triggering greater pain sensitivity at tender points.

The Bone Resorption Assessment is a noninvasive analysis of Pdy/D-pyd crosslinks in urine, important for the evaluating risk and prognosis of many bone- and connective tissue-related conditions, including arthritides, metabolic bone diseases, and osteoporosis.

References:
1 Sprott H, Muller A, Heine H.Collagen cross-links in fibromyalgia syndrome. Z Rheumatol 1998;57 Suppl 2:52-5.

2 Sprott H, Muller A, Heine H. Collagen crosslinks in fibromyalgia. Arthritis Rheum 1997 Aug;40(8):1450-4.


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