title: Prognostic interest of bone turnover markers in the management of postmenopausal osteoporosis.
abstract: OBJECTIVE
  The aim was to review the literature dealing with the use of biochemical bone turnover markers (BTM) as predictors of bone loss and individual risk of fracture in postmenopausal osteoporosis.
  
  
  METHODS
  We performed a generalized search in MEDLINE using Mesh Database from 1995 through 2009 with the following terms "biological markers" with "osteoporosis" or "bone resorption", or "bone fracture", "fracture risk". From this research, 197 abstracts were read, 91 articles were screened then 43 original articles were selected.
  
  
  RESULTS
  In most of the selected articles, the upper limit of the premenopausal range was used as a cut-off definition for increased bone resorption. Based on this review, we found a moderate and positive relationship between baseline level of BTM and rate of bone loss, more particularly for high level of BTM over 2 SD, especially when high turnover is constant in repeated sampling. In addition, an increase in BTM levels is associated with an increase in the risk of hip and non-vertebral fractures in elderly women over 75 years old. This is especially demonstrated with bone resorption markers (e.g. uCTX) in the highest quartile with an 1.7 to 2.2 fold increase. The combination of data from bone mineral density (BMD) and bone resorption markers may improve fracture prediction.
  
  
  CONCLUSIONS
  The measurement of BTM, together with the assessment of other risk factors including low BMD, will improve the prediction of risk fracture, but there is a lack of practical guidelines.
authors: Inserm U1059, Department of Rheumatology, University Hospital of Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: Florence
authors: F
authors: Chopin
authors: Emmanuel
authors: E
authors: Biver
authors: Thomas
authors: T
authors: Funck-Brentano
authors: Béatrice
authors: B
authors: Bouvard
authors: Guillaume
authors: G
authors: Coiffier
authors: Patrick
authors: P
authors: Garnero
authors: Thierry
authors: T
authors: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D001862:Bone Resorption / Q000175:diagnosis* / Q000378:metabolism; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D016239:MEDLINE; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000378:metabolism; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000378:metabolism; D010455:Peptides / Q000097:blood; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide