title: Clinical usefulness of bone turnover marker concentrations in osteoporosis.
abstract: Current evidence continues to support the potential for bone turnover markers (BTM) to provide clinically useful information particularly for monitoring the efficacy of osteoporosis treatment. Many of the limitations identified earlier remain, principally in regard to the relationship between BTM and incident fractures. Important data are now available on reference interval values for CTX and PINP across a range of geographic regions and for individual clinical assays. An apparent lack of comparability between current clinical assays for CTX has become evident indicating the possible limitations of combining such data for meta-analyses. Harmonization of units for reporting serum/plasma CTX (ng/L) and PINP (μg/L) is recommended. The development of international collaborations continues with an important initiative to combine BTM results from clinical trials in osteoporosis in a meta-analysis and an assay harmonization program are likely to be beneficial. It is possible that knowledge derived from clinical studies can further enhance fracture risk estimation tools with inclusion of BTM together with other independent risk factors. Further data of the relationships between the clinical assays for CTX and PINP as well as physiological and pre-analytical factors contributing to variability in BTM concentrations are required.
authors.affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia. Electronic address: Howard.Morris@sa.gov.au.
authors.forename: H A
authors.initials: HA
authors.lastname: Morris
authors.affiliation: Mellanby Centre for Bone Research, University of Sheffield and Metabolic Bone Centre, Northern General Hospital, Herries Road, Sheffield, UK.
authors.forename: R
authors.initials: R
authors.lastname: Eastell
authors.affiliation: Research Centre for Aging and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Ndr Ringvej 57-59, DK-2600 Glostrup, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: N R
authors.initials: NR
authors.lastname: Jorgensen
authors.affiliation: University of Liège, CHU Sart-Tilman, Domaine du Sart-Tilman, B-4000 Liège, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Cavalier
authors.affiliation: Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Vasikaran
authors.affiliation: Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
authors.forename: S A P
authors.initials: SAP
authors.lastname: Chubb
authors.affiliation: Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Kanis
authors.affiliation: The MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cooper
authors.affiliation: Clinical Biochemistry Department, KAT General Hospital, 14651 Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Makris
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D016723:Bone Remodeling; D006801:Humans; D010024:Osteoporosis / Q000378:metabolism* / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000378:metabolism; D012015:Reference Standards; D018570:Risk Assessment
chemical_list: D015415:Biomarkers
keywords: Bone turnover markers; CTX; Fracture risk; Monitoring efficacy for treatment of osteoporosis; Osteoporosis; PINP; Reference intervals