Amino Acids (Urine) test [Great Plains Laboratory / Doctor's Data]

Hydroxyproline

Optimal Result: 0 - 40 qM/g creatinine.

As a major part of collagen, hydroxyproline has an essential role in collagen stability. Small amounts of hydroxyproline are also found in the following:

- Elastin

- Acetylcholinesterase

- The C1q component of the complement system

- The macrophage scavenger proteins

- Ectodysplasin A

Two isomeric forms of hydroxyproline have been identified in collagen. Trans-4-hydroxy-L-proline is found in type I and type III collagen, whereas higher amounts of trans-3-hydroxy-L-proline are found in type IV collagen. Normal secretion of procollagen molecules out of the cells requires a critical amount of trans-4-hydroxy-L-proline. Therefore, without hydroxyproline, no functional collagen fibers appear in the extracellular space.

Hydroxyproline can be tested in the serum and in the urine. The serum level of hydroxyproline excretion correlates well with its urinary level. However, urinary hydroxyproline better discriminates (x 100) between normal and metastatic disease of the bone.

In addition to the substrate, hydroxylation of peptidyl prolyl and peptidyl lysyl residues, catalyzed by prolyl hydroxylase and lysyl hydroxylase of skin, skeletal muscle, and granulating wounds, requires molecular oxygen, ascorbate, Fe2+, and alpha-ketoglutarate. A vitamin C deficiency can lead to scurvy, which produces bleeding gums, swelling joints, and impaired wound healing result due to the impaired collagen stability.

Indications/Applications:

Hydroxyproline testing is indicated for the following:

- Paget disease of bone or to detect the inflammatory or neoplastic involvement of the bone

- As an indicator of activity in acromegaly and response to treatment to growth hormone

- As a diagnostic aid in Marfan syndrome

Considerations:

Hyperhydroxyprolinemia is a benign condition caused by a defect in 4-hydroxyproline dehydrogenase. No impairment of proline catabolism is associated with this condition.

The ratio of hydroxyproline/creatinine in a fresh specimen of early morning urine, considered the total urinary hydroxyproline, is the best index of collagen breakdown in metastatic bone disease. This measurement is preferable to free serum hydroxyproline measurement in this setting.

Although serum hydroxyproline and urinary hydroxyproline measurements are strongly correlated, urinary hydroxyproline measurement in 24-hour or spot urine is easier to collect. Spot urine testing is measurement of choice in screening for bony involvement by malignancy because collagen intake does not influence hydroxyproline/creatinine.

In individuals with bony metastases (most notably those with prostate cancer), increases in serum and urine hydroxyproline levels are observed prior to radiographic evidence of metastatic lesions; thus, these measurements are potential markers of skeletal metastatic disease and may be recommended in settings where advanced imaging modalities are not readily available. Moreover, hydroxyproline level measurements may permit illness monitoring and assessment of treatment response in such settings.

-----------------------

Hydroxyproline is a collagen related amino acid. Hydroxyproline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver. Hydroxyproline is necessary for the construction of the body’s major structural protein, collagen. Hydroxyproline is present in essentially all tissues and all genetic types of collagen. [1]

Defects in collagen synthesis lead to easy bruising, internal bleeding, breakdown of connective tissue of the ligaments and tendons, and increased risk to blood vessel damage.

Hydroxyproline’s immediate precursor is proline. The conversion of proline to hydroxyproline requires vitamin C (ascorbic acid). Vitamin C deficiency results in the poor conversion of proline to hydroxyproline.

References

Serge Cremers, Patrick Garnero, Markus J Seibel, Chapter 87 - Biochemical Markers of Bone Metabolism, Editor(s): John P. Bilezikian, Lawrence G. Raisz, T. John Martin, Principles of Bone Biology (Third Edition), Academic Press, 2008, Pages 1857-1881 [1]

Wheeless' Textbook of Orthopaedics Presented by Duke Orthopaedics, Pagets Disease [2]

Laitinen O, Nikkila EA, Kivirikko KI. Hydroxyproline in the serum and urine. Normal values and clinical significance. Acta medica Scandinavica. Mar 1966. 179(3):275-284. [3]

Klein L. Urinary Hydroxyproline during Late Pregnancy and Postpartum Involution. Metabolism: clinical and experimental. May 1964. 13:386-390. [4]

Krane SM, Simon LS. Metabolic consequences of bone turnover in Paget's disease of bone. Clin Orthop Relat Res. Apr 1987. (217):26-36. [5]

Wheeless, CM. Wheeless Textbook of Orthopaedics. United States: 1996. 386-390. [6]

Pagets Disease. Wheeless, CR, Urbaniak JR, eds. Wheeless' Textbook of Orthopaedics. 1996. [7]

Gasser AB, Depierre D, Courvoisier B. Total urinary and free serum hydroxyproline in metastatic bone disease. Br J Cancer. Mar 1979. 39(3):280-283. [8]

What does it mean if your Hydroxyproline result is too high?

- Collagen synthesis requires iron, alpha-ketoglutarate and vitamin C. Chondroitin sulfate and manganese can also be helpful.

- Elevated urinary hydroxyproline is a reflection of bone lysis and may also occur in RA, hyperparathyroidism, and OM; [2]

- Increased serum and urine levels of hydroxyproline have been demonstrated in Paget’s disease [2]

-------

The following conditions are associated with increased hydroxyproline levels: [3, 4, 5, 6, 7, 8]

- Paget disease

- Rheumatoid arthritis

- Hyperparathyroidism

- Osteomyelitis

- Polyarteritis nodosa

- Marfan syndrome

- Acromegaly

- Hyperthyroidism

- Turner syndrome

- Skeletal metastases

- Pregnancy

10 000+ happy clients
100% satisfaction
★ ★ ★ ★ ★ customer support

Understand blood, stool, and urine medical results from all your laboratories.

Get Started With Our Personal Plan

Advanced Plan

  • ✓ Yearly subscription
  • ✓ Five free uploads
  • ✓ Cancel anytime
  • ✓ Instant interpretations
  • ✓ Use the free self-upload form
  • ✓ 3000+ biomarkers explained
  • ✓ Nutrition Recommendations
  • ✓ Dedicated support
  • ✓ Yearly subscription
  • ✓ Five free uploads
  • ✓ Cancel anytime
$79 per year
  • ✓ Instant interpretations
  • ✓ Use the free self-upload form
  • ✓ 3000+ biomarkers explained
  • ✓ Nutrition Recommendations
  • ✓ Dedicated support

Unlimited Plan

  • ✓ No subscription
  • ✓ Ten free uploads
  • ✓ Unlimited access
  • ✓ Instant interpretations
  • ✓ Use the free self-upload form
  • ✓ 3000+ biomarkers explained
  • ✓ Nutrition Recommendations
  • ✓ Dedicated support
  • ✓ No subscription
  • ✓ Ten free uploads
  • ✓ Unlimited access
$250 full version

Are You a Health Professional?

Get started with our professional plan

Welcome to Healthmatters Pro.

Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place. Learn more

Pro Plan

for health professionals

  • ✓ Track multiple clients results
  • ✓ No setup fees
  • ✓ No hidden costs
  • ✓ Cancel anytime
  • ✓ Instant interpretations
  • ✓ Use the free template forms
  • ✓ 3000+ biomarkers explained
  • ✓ Additional team member $25
  • ✓ Personal training and support

$45 per month

Use promo code to save 10% off any plan.


We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.

×

Understand Your Lab Result Now

  • Instant interpretation
  • 3000+ biomarkers explained
  • Science-based recommendations
  • Online support
  • Secure and private portal

Get 10% off with promocode: