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.
Université Laval, Québec, QC, Canada. jacques.brown@crchul.ulaval.ca
Jacques P
JP
Brown
Caroline
C
Albert
Bassam A
BA
Nassar
Jonathan D
JD
Adachi
David
D
Cole
K Shawn
KS
Davison
Kent C
KC
Dooley
Andrew
A
Don-Wauchope
Pierre
P
Douville
David A
DA
Hanley
Sophie A
SA
Jamal
Robert
R
Josse
Stephanie
S
Kaiser
John
J
Krahn
Richard
R
Krause
Richard
R
Kremer
Raymond
R
Lepage
Elaine
E
Letendre
Suzanne
S
Morin
Daylily S
DS
Ooi
Alexandra
A
Papaioaonnou
Louis-Georges
LG
Ste-Marie
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