Osteocalcin, Serum
Medical Test

Overview

Osteocalcin is the major non-collagen calcium binding protein and it is excreted by osteoblasts in the bone. The serum concentrations are an indication of bone formation. The synthesis of osteocalcin is vitamin D independent. Elevated results are usually associated with increased bone turnover such as what is seen in osteoporosis. Bisphosphonated drugs used to treat osteoporosis can be monitored for effectiveness by measuring osteocalcin levels. Levels are normally high in childhood and then peak in early puberty. During menopause a second peak usually occurs in females.

Although results are not strictly diagnostic of osteoporosis, a decrease in the value can be interpreted as evidence of a favorable response to treatment. Patients that are on vitamin K antagonist medication can have unreliable results. Therefore, ELISA methodology is the best choice to test for undercarboxylated osteocalcin. This assay should be used in conjunction with other bone markers for best interpretation. Bone mineral densitometry and imaging studies are the gold standard for the evaluation of osteoporosis. Bone formation/ resorption may be accurately reflected in patients taking 1,25-dihydroxyvitamin D or if there is an abnormality with it.

Of note, bone formation and serum Osteocalcin level follows a diurnal rhythm and is also subject to the menstrual cycle. Variation by as much as 50% can be seen from a nocturnal peak to a morning low, with a 10% day to day variation, and as large as a 60% increase can be seen following a fracture.

Clinical Utility

  • As an aid in monitoring mineral and bone metabolism
  • Determine efficacy of therapy in osteoporosis and metastatic bone disease
  • Monitoring bone metabolic changes secondary to Cushing syndrome
  • Monitoring bone metabolic changes secondary to primary hyperparathyroidism
  • Monitoring bone metabolic changes secondary to malabsorption syndrome
  • As an aid in diagnosis of plasma cell myeloma
  • Selection of therapy for patients with hypercalciuria

Interpretation

Increased in:

  • Primary or secondary osteoporosis
  • Osteomalacia
  • Osteopenia due to vitamin D deficiency
  • Growth hormone deficiency
  • Hypogonadism
  • Paget’s disease
  • Osteoporosis
  • Cushing syndrome
  • Renal osteodystrophy
  • Inflammatory states such as rheumatoid arthritis
  • Bone metastasis
  • Hyperthyroidism
  • Primary Hyperparathyroidism
  • Myeloma
  • Hypercalciuria
  • Children
  • Long term corticosteroid use
  • Acromegaly
  • Recent bone fracture
  • Menopause
  • Lactation
  • Excercise
  • Incresed age

Decreased in:

  • Decreased results may indicate favorable therapeutic response
  • Pregnancy
  • Growth hormone deficiency
  • Hypothyroidism
  • Hypoparathyroidism
  • Liver disease
  • Alcoholism
  • Long term corticosteroid therapy
  • Obesity
  • Type 2 Diabetes

Reference Ranges

Age / Sex ng/mL or µg/L
Child 6–9.9 yr 40.2–108
10–13.9 yr 35.8–166
14–17.9 yr Male 27.8–194
14–17.9 yr Female 16.3–68.7
Adult Male 11.3–35.4
Adult Male 1.1–7.2
Female, Premenopausal 0.5–7.0

Methodology

Chemiluminescent immunoassay, enzyme immunoassay, enzyme-linked immunosorbent assay (ELISA).

Specimen Collection

Serum Red top preferred, Serum gel(SST) acceptable.

Must be fasting.
Separate within 1 hour and freeze.

Additional Testing

Alkaline Phosphatase, Alkaline Phosphatase isoenzyme, Calcium Levels, Vitamin D, Parathyroid Hormone, Liver profile, Phosphorus.

CPT
83937$29.85

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Showing results for all states.
Filter:
ICD10 CODE AND DESCRIPTIONLCD CODENCD CODE
A49 - Bacterial infection of unspecified site——
A49.9 - Bacterial infection, unspecified——
C40 - Malignant neoplasm of bone and articular cartilage of limbs——
C40.0 - Malignant neoplasm of scapula and long bones of upper limb——
C40.00 - Malignant neoplasm of scapula and long bones of unspecified upper limb——
C40.01 - Malignant neoplasm of scapula and long bones of right upper limb——
C40.02 - Malignant neoplasm of scapula and long bones of left upper limb——
C40.1 - Malignant neoplasm of short bones of upper limb——
C40.10 - Malignant neoplasm of short bones of unspecified upper limb——
C40.11 - Malignant neoplasm of short bones of right upper limb——
C40.12 - Malignant neoplasm of short bones of left upper limb——
C40.2 - Malignant neoplasm of long bones of lower limb——
C40.20 - Malignant neoplasm of long bones of unspecified lower limb——
C40.21 - Malignant neoplasm of long bones of right lower limb——
C40.22 - Malignant neoplasm of long bones of left lower limb——
C40.3 - Malignant neoplasm of short bones of lower limb——
C40.30 - Malignant neoplasm of short bones of unspecified lower limb——
C40.31 - Malignant neoplasm of short bones of right lower limb——
C40.32 - Malignant neoplasm of short bones of left lower limb——
C40.8 - Malignant neoplasm of overlapping sites of bone and articular cartilage of limb——
C40.80 - Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb——
C40.81 - Malignant neoplasm of overlapping sites of bone and articular cartilage of right limb——
C40.82 - Malignant neoplasm of overlapping sites of bone and articular cartilage of left limb——
C40.9 - Malignant neoplasm of unspecified bones and articular cartilage of limb——
C40.90 - Malignant neoplasm of unspecified bones and articular cartilage of unspecified limb——
C40.91 - Malignant neoplasm of unspecified bones and articular cartilage of right limb——
C40.92 - Malignant neoplasm of unspecified bones and articular cartilage of left limb——
C41 - Malignant neoplasm of bone and articular cartilage of other and unspecified sites——
C41.0 - Malignant neoplasm of bones of skull and face——
C41.1 - Malignant neoplasm of mandible——
C41.2 - Malignant neoplasm of vertebral column——
C41.3 - Malignant neoplasm of ribs, sternum and clavicle——
C41.4 - Malignant neoplasm of pelvic bones, sacrum and coccyx——
C41.9 - Malignant neoplasm of bone and articular cartilage, unspecified——
C75 - Malignant neoplasm of other endocrine glands and related structures——
C75.0 - Malignant neoplasm of parathyroid gland——
C75.9 - Malignant neoplasm of endocrine gland, unspecified——
C77 - Secondary and unspecified malignant neoplasm of lymph nodes——
C77.0 - Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck——
C77.9 - Secondary and unspecified malignant neoplasm of lymph node, unspecified——
C78.01 - Secondary malignant neoplasm of right lung——
C78.02 - Secondary malignant neoplasm of left lung——
C79 - Secondary malignant neoplasm of other and unspecified sites——
C79.51 - Secondary malignant neoplasm of bone——
C79.52 - Secondary malignant neoplasm of bone marrow——
C79.9 - Secondary malignant neoplasm of unspecified site——
C90.00 - Multiple myeloma not having achieved remission——
D16 - Benign neoplasm of bone and articular cartilage——
D16.0 - Benign neoplasm of scapula and long bones of upper limb——
D16.00 - Benign neoplasm of scapula and long bones of unspecified upper limb——

Additional ICD10
  • AK - Alaska
  • AL - Alabama
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  • VT - Vermont
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  • CNMI - Northern Mariana Islands
  • EM - Missouri - Northeastern & Southern
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  • DN - New York - Downstate
  • QN - New York - Queens
  • UN - New York - Upstate
  • NF - California - Northern
  • SF - California - Southern
Showing results for all states.
Filter:
ICD10 CODE AND DESCRIPTIONLCD CODENCD CODE
A49.0 - Staphylococcal infection, unspecified site——
A49.01 - Methicillin susceptible Staphylococcus aureus infection, unspecified site——
A49.02 - Methicillin resistant Staphylococcus aureus infection, unspecified site——
A49.1 - Streptococcal infection, unspecified site——
A49.2 - Hemophilus influenzae infection, unspecified site——
A49.3 - Mycoplasma infection, unspecified site——
A49.8 - Other bacterial infections of unspecified site——
A49.9 - Bacterial infection, unspecified——
C40.0 - Malignant neoplasm of scapula and long bones of upper limb——
C40.00 - Malignant neoplasm of scapula and long bones of unspecified upper limb——
C40.01 - Malignant neoplasm of scapula and long bones of right upper limb——
C40.02 - Malignant neoplasm of scapula and long bones of left upper limb——
C40.1 - Malignant neoplasm of short bones of upper limb——
C40.10 - Malignant neoplasm of short bones of unspecified upper limb——
C40.11 - Malignant neoplasm of short bones of right upper limb——
C40.12 - Malignant neoplasm of short bones of left upper limb——
C40.2 - Malignant neoplasm of long bones of lower limb——
C40.20 - Malignant neoplasm of long bones of unspecified lower limb——
C40.21 - Malignant neoplasm of long bones of right lower limb——
C40.22 - Malignant neoplasm of long bones of left lower limb——
C40.3 - Malignant neoplasm of short bones of lower limb——
C40.30 - Malignant neoplasm of short bones of unspecified lower limb——
C40.31 - Malignant neoplasm of short bones of right lower limb——
C40.32 - Malignant neoplasm of short bones of left lower limb——
C40.8 - Malignant neoplasm of overlapping sites of bone and articular cartilage of limb——
C40.80 - Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb——
C40.81 - Malignant neoplasm of overlapping sites of bone and articular cartilage of right limb——
C40.82 - Malignant neoplasm of overlapping sites of bone and articular cartilage of left limb——
C40.9 - Malignant neoplasm of unspecified bones and articular cartilage of limb——
C40.90 - Malignant neoplasm of unspecified bones and articular cartilage of unspecified limb——
C40.91 - Malignant neoplasm of unspecified bones and articular cartilage of right limb——
C40.92 - Malignant neoplasm of unspecified bones and articular cartilage of left limb——
C41.0 - Malignant neoplasm of bones of skull and face——
C41.1 - Malignant neoplasm of mandible——
C41.2 - Malignant neoplasm of vertebral column——
C41.3 - Malignant neoplasm of ribs, sternum and clavicle——
C41.4 - Malignant neoplasm of pelvic bones, sacrum and coccyx——
C41.9 - Malignant neoplasm of bone and articular cartilage, unspecified——
C75.0 - Malignant neoplasm of parathyroid gland——
C75.1 - Malignant neoplasm of pituitary gland——
C75.2 - Malignant neoplasm of craniopharyngeal duct——
C75.3 - Malignant neoplasm of pineal gland——
C75.4 - Malignant neoplasm of carotid body——
C75.5 - Malignant neoplasm of aortic body and other paraganglia——
C75.8 - Malignant neoplasm with pluriglandular involvement, unspecified——
C75.9 - Malignant neoplasm of endocrine gland, unspecified——
C77.0 - Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck——
C77.1 - Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes——
C77.2 - Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes——
C77.3 - Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes——

References

  • JAMA. 2001; 285:785-95. [PMID: 11176917]
  • Clin Calcium. 2009 Dec;19(12):1815-21. [PMID: 19949273]
  • J Cell Biochem. 1995 Mar;57(3):379-83. [PMID: 7768973]
  • Clin Orthop Relat Res. 1988 Jan;(226):267-91. [PMID: 3275514]
  • Alan Wu. Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders; 4 edition (June 13, 2006). ISBN-10: 0721679757