Collagen is the major structural component of the human body and there are many clinical reasons why it is desirable to determine its turnover rate. Biomarkers are increasingly used as diagnostic and prognostic tools as well as for monitoring therapy. At present, there is considerable interest in the application of biochemical markers of bone turnover to diseases such as osteoporosis, bone cancer arid the arthropathies where the ideal biomarker should correlate with disease progression and provide a differential diagnosis. As biochemical knowledge and analytical technology progress, previously accepted biomarkers are being discarded and new, supposedly more specific, markers evaluated. The usefulness of a biomarker depends on an understanding of its origin and the ease of measuring it in biological fluids. Collagen, the most abundant protein in the human body, constitutes approximately 30% of body protein, with up to 40% in skin and 50% in bone.' To date, some 18 collagens have been characterized.? representing a closely related family of glycoproteins each with a specific synthetic route and different functionality. The collagen family is coded for by over 30 genes dispersed through at least nine different chromosomes.' The major collagen, type I, is ubiquitously distributed and forms the major protein in bone, skin, tendon, ligament, sclera, cornea, blood vessels and hollow organs. However, dermal type I collagen is structurally and functionally dissimilar to that found in bone. Many minor collagens are found in association with the principal collagens (types I, II, III, IV), and, whilst their presence may be