title: Bone Turnover Markers in the Diagnosis and Monitoring of Metabolic Bone Disease.
abstract: BACKGROUND
  Disorders of bone metabolism, most notably osteoporosis, are highly prevalent and predispose to fractures, causing high patient morbidity and mortality. Diagnosis and monitoring of bone metabolic defects can present a major challenge as these disorders are largely asymptomatic and radiographic measures of bone mass respond slowly to changes in bone physiology.
  
  
  BACKGROUND
  Bone turnover markers (BTMs) are a series of protein or protein derivative biomarkers released during bone remodeling by osteoblasts or osteoclasts. BTMs can offer prognostic information on fracture risk that supplements radiographic measures of bone mass, but testing using BTMs has to take into account the large number of preanalytic factors and comorbid clinical conditions influencing BTM levels. BTMs respond rapidly to changes in bone physiology, therefore, they have utility in determining patient response to and compliance with therapies for osteoporosis.
  
  
  CONCLUSIONS
  BTMs are a useful adjunct for the diagnosis and therapeutic monitoring of bone metabolic disorders, but their use has to be tempered by the known limitations in their clinical utility and preanalytic variables complicating interpretation.
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; mag3003@med.cornell.edu.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Greenblatt
authors.affiliation: Endocrine Unit, Massachusetts General Hospital, Boston, MA.
authors.forename: Joy N
authors.initials: JN
authors.lastname: Tsai
authors.affiliation: Endocrine Unit, Massachusetts General Hospital, Boston, MA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Wein
mesh_terms: D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001851:Bone Diseases, Metabolic / Q000175:diagnosis* / Q000378:metabolism; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D006801:Humans
chemical_list: D015415:Biomarkers