What is the CrossLaps – Serum Deoxypyridinoline (DPD) test?

The CrossLaps (DPD) blood test measures fragments released into the bloodstream when bone collagen is broken down. Deoxypyridinoline (DPD) is a specific cross-link of type I collagen, which is the main structural protein in bone.

When bone resorption increases, DPD levels rise, making this test a sensitive indicator of active bone loss. It reflects real-time skeletal turnover rather than bone density alone.

Clinically, CrossLaps testing is used in the assessment of osteoporosis, metabolic bone disorders, and to monitor response to treatments that aim to reduce bone breakdown.

Why do I need a CrossLaps (DPD) test?

Bone loss often occurs silently, without symptoms, until fractures develop. Measuring bone resorption markers like DPD helps identify excessive bone breakdown early, before irreversible damage occurs.

This test is particularly useful alongside bone density scans (DEXA), as it shows how fast bone is being lost, not just how dense it currently is.

You may benefit from a CrossLaps (DPD) test if you:

• Have osteoporosis or osteopenia
• Are postmenopausal
• Have a history of fractures
• Are on steroid medication
• Have thyroid or parathyroid disorders
• Have suspected metabolic bone disease
• Are monitoring osteoporosis treatment
• Have unexplained bone pain
• Are at increased fracture risk

DPD testing is also valuable for evaluating treatment effectiveness within months rather than years.

Benefits of the CrossLaps (DPD) test

• Assesses active bone breakdown
  Detects increased bone resorption.
• Supports osteoporosis diagnosis
  Complements bone density scanning.
• Monitors treatment response
  Shows whether therapy is reducing bone loss.
• Identifies early bone metabolism changes
  Useful before fractures occur.
• Supports fracture risk assessment
  High levels correlate with increased risk.
• Sensitive and specific marker
  Reflects type I collagen degradation.
• Useful in hormonal bone disorders
  Relevant in menopause and endocrine disease.
• Simple blood test
  No imaging or invasive procedures required.

Step by step – how the test works

You can access CrossLaps (DPD) testing UK-wide using one of the following options:

1. Clinic appointment
   Choose your nearest UK clinic. A healthcare professional will take your blood sample.
2. At-home or hotel visit (£60 extra)
   A qualified phlebotomist visits your home or hotel, so you don’t need to travel.

Your sample is analysed in a UK laboratory and results are delivered securely.

Your results explained

Low DPD levels

Suggest low bone turnover. This may be seen with effective osteoporosis treatment or reduced bone remodelling.

Typical UK reference range:

• Women: ~ 0.1–0.7 ng/mL
• Men: ~ 0.2–0.9 ng/mL

Normal DPD levels

Indicate balanced bone turnover, with normal rates of bone breakdown and renewal.

Typical UK reference range:

• Within laboratory-specific age and sex ranges

High DPD levels

Indicate increased bone resorption. This may occur in osteoporosis, menopause, hyperthyroidism, or untreated metabolic bone disease and is associated with higher fracture risk.

Typical UK reference range:

• Above laboratory-specific upper limit

Reference ranges vary by laboratory and clinical context.