Serum carboxy-terminal telopeptide of type I collagen levels are associated with carotid atherosclerosis in patients with cardiovascular risk factors

Endocr J. 2016 Apr 25;63(4):397-404. doi: 10.1507/endocrj.EJ15-0589. Epub 2016 Feb 13.


Carboxy-terminal telopeptide of type I collagen (ICTP) is generated through matrix metalloproteinase (MMP)-dependent type I collagen digestion, and has been widely utilized as a biomarker for bone turnover. The fact that atherosclerotic lesions are rich in both type I collagen and MMP-producing macrophages led to the hypothesis that serum ICTP concentrations may serve as a non-invasive clinical biomarker for atherosclerosis. Therefore, the association of serum ICTP concentrations with the maximum intima-media thickness (IMT) of carotid arteries, a surrogate index of systemic atherosclerosis, or brachial-ankle pulse wave velocity (baPWV) in patients with atherosclerotic risk factors was evaluated. A total of 52 male and 65 female (mean age: 62.8 yrs) patients without renal failure, malignancies or bone diseases known to affect serum ICTP concentrations were recruited. Patients with max IMTs ≥1.1 mm showed significantly higher serum ICTP concentrations compared with patients with max IMTs <1.1 mm (3.33 ± 0.97 vs 2.82 ± 0.65 ng/mL, p<0.05). Serum ICTP concentration was also positively correlated with max IMT (p<0.001) or baPWV values (p<0.05). Multivariate analyses also revealed that serum ICTP concentrations were correlated with max IMT (p<0.001; 95% CI 0.200 to 0.454). These results suggest that serum ICTP concentrations can be used as a non-invasive biomarker for systemic atherosclerosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ankle Brachial Index
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / physiopathology
  • Carotid Artery Diseases / blood*
  • Carotid Artery Diseases / physiopathology*
  • Carotid Intima-Media Thickness
  • Collagen Type I / blood*
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peptides / blood*
  • Pulse Wave Analysis
  • Risk Factors


  • Collagen Type I
  • Peptides
  • collagen type I trimeric cross-linked peptide