Bone turnover markers in the management of postmenopausal osteoporosis.
Osteoporosis is the most common cause of fragility fractures. Bone remodelling is essential for repairing damaged areas within bone to preserve bone strength and for assisting in mineral homeostases. In young adults, bone remodelling is usually balanced with approximately as much bone replaced as is removed during each remodelling cycle. However, when remodelling becomes accelerated in combination with an imbalance that favours bone resorption over formation, such as during menopause, precipitous losses in bone mass occur. Bone turnover markers (BTMs) measure the rate of bone remodelling allowing for a dynamic assessment of skeletal status and hold promise in identifying those at highest risk of rapid bone loss and subsequent fracture. Further, the use of BTMs to monitor individuals administered osteoporosis therapy is attractive as monitoring anti-fracture efficacy with bone mineral density has significant limitations. This review details remodelling biology, pre-analytical and analytical sources of variability for BTMs, describes the most commonly used resorption and formation markers, and offers some guidelines for their use and interpretation in the laboratory and the clinic.
Brown
Jacques P
JP
Université Laval, Québec, QC, Canada. jacques.brown@crchul.ulaval.ca
Albert
Caroline
C
Nassar
Bassam A
BA
Adachi
Jonathan D
JD
Cole
David
D
Davison
K Shawn
KS
Dooley
Kent C
KC
Don-Wauchope
Andrew
A
Douville
Pierre
P
Hanley
David A
DA
Jamal
Sophie A
SA
Josse
Robert
R
Kaiser
Stephanie
S
Krahn
John
J
Krause
Richard
R
Kremer
Richard
R
Lepage
Raymond
R
Letendre
Elaine
E
Morin
Suzanne
S
Ooi
Daylily S
DS
Papaioaonnou
Alexandra
A
Ste-Marie
Louis-Georges
LG
D015415:Biomarkers / Q000378:metabolism; D016723:Bone Remodeling / Q000502:physiology*; D001862:Bone Resorption / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D010012:Osteogenesis / Q000502:physiology; D015663:Osteoporosis, Postmenopausal / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy*
D015415:Biomarkers