Total Procollagen 1 N-Terminal Propeptide (P1NP)
During the renewal of the skeleton, type 1 procollagen's amino- and carboxy-terminal regions are cleaved by specific proteases during its conversion to collagen and subsequent incorporation into bone matrix. The presence of these N-terminal extension propeptides, known as type 1 procollagen amino terminal peptides (P1NP), therefore reflects the deposition of collagen and can be defined as a marker of bone formation. P1NP is released into the blood stream during type 1 collagen formation. Elevated levels are found in patients with increased bone turnover. As a bone marker, it may be use in the assesment of bone turnvoer in metabolic bone disease and monitoring of therapy and is specifically used for monitoring of bone formation during anabolic therapy.
Assessing treatment response and compliance to osteoporosis therapy (such as bisphosphonates), but specifically the response to treatment by human PTH (Teriparatide).
Pre-menopausal women: 15.1-58.6 ng/mL.
The least significant change for serum P1NP is ±25 %, with a reasonable response to hPTH therapy being an increase of at least ≥40 % (a very good response to therapy being an increase of between 100-200 %). Note that post-menopausal reference ranges are poorly defined. A post-menopausal reference range is available on request and is suitable for research studies only.
Time of collection: if monitoring response to treatment, samples should be collected at the same time of day e.g. always a morning clinic, or always an afternoon clinic. Ideally a morning fasting sample should be collected . Serial measurements on the same patient are recommended before therapy and at 3 and 6 months after therapy (and at subsequent 3, 6 or 12 monthly intervals as required).
If monitoring the response to treatment, the sample should be collected at the same time of day.
Falsely low results may be obtained for this test due to biotin interference. Samples should not be taken from patients receiving therapy with high biotin doses (>5 mg/day) until at least 8 hours (ideally 2 days) following the last biotin administration.
Grossly haemolysed samples are unsuitable for this assay.
Record last updated
August 28, 2025
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5ml SST Vacutainers (Gold / Yellow top)
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4ml EDTA Vacutainers (Lavender top)
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6ml Lithium Heparin (Green top)
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Test Results
Yes, we have a Pathology User Guide
Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net
Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page
Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net
Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.
Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.
Different tests have different sample stability requirements. If a comment on results indicates that the sample was delayed, the links below will indicate which tests may have been affected. This information is for serum or plasma samples.
For some tests, the impact of delay is consistent and these are marked with an arrow:
↑ indicates tests where delayed centrifugation results in falsely elevated results and the true level is likely lower than that reported.
↓ indicates tests where delayed centrifugation results in falsely lowered results and the true level is likely higher than that reported.
If there is no arrow, the true level may be lower or higher than reported.
Please interpret results with caution and consider the impact of any uncertainty.
The comment on the report will state how delayed the sample was. Please click the relevant link below to see which other tests may have been affected.
| >8h | >12h | >24h | >48h | >72h |
Phlebotomy services are not managed by NWLP. For further information please see:
Imperial College Healthcare Trust Phlebotomy services
Chelsea and Westminster Hospital NHS Foundation Trust Phlebotomy services
NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.
UKAS accredited medical laboratory/medical diagnostic service:
- Clinical Biochemistry No. 8673
- Haematology and Blood Transfusion No. 8674
- Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) No. 8659
- Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) No. 9615
If you require copies of our certificate of accreditation and associated documentation please contact Imperial.nwlpcustomerservice@nhs.net.
UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).
The BD Hospital Tube Guide, BD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.
Home testing
INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION
We also have two instruction videos available (one with subtitles and one without) – please click on the links to view the videos on Google.
Our accreditations
Upholding excellence in diagnostic standards
Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.
Find out more about our accreditations on the UKAS website.
UKAS website