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Clinical Use of Biochemical Markers of Bone Remodeling: Current Status and Future Directions
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Clinical Use of Biochemical Markers of Bone Remodeling: Current Status and Future Directions
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Journal Article
Clinical Use of Biochemical Markers of Bone Remodeling: Current Status and Future Directions
2000
Overview
Biochemical markers of bone turnover provide a means of evaluating skeletal dynamics that complements static measurements of bone mineral density (BMD). This review evaluates the use of commercially available bone turnover markers as aids in diagnosis and monitoring response to treatment in patients with osteoporosis. High within-person variability complicates but does not preclude their use. Elevated bone resorption markers appear to be associated with increased fracture risk in elderly women, but there is less evidence of a relationship between bone formation markers and fracture risk. The critical question of predicting fracture efficacy with treatment has not been answered. Changes in bone markers as currently determined do not predict BMD response to either bisphosphonates or hormone replacement therapy. Single measurements of markers do not predict BMD cross-sectionally (except possibly in the very elderly), or change in BMD in individual patients, either treated or untreated. On the other hand, research applications of bone turnover markers are of value in investigating the pathogenesis and treatment of bone diseases. Markers have potential in the clinical management of osteoporosis, but their use in this regard is not established. Additional studies with fracture endpoints and information on negative and positive predictive value are needed to evaluate fully the utility of bone turnover markers in individual patients.
Publisher
Springer,Springer Nature B.V
Subject
Biological and medical sciences
/ Bone Remodeling - physiology
/ Bone Resorption - metabolism
/ Female
/ Fractures, Bone - metabolism
/ Humans
/ Investigative techniques, diagnostic techniques (general aspects)
/ Osteoarticular system. Muscles
/ Osteoporosis - physiopathology
/ Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
