Practical Considerations for the Clinical Application of Bone Turnover Markers in Osteoporosis.

Bone turnover markers; Bone-specific isoenzyme of alkaline phosphatase (B-ALP); C-terminal telopeptide of type I collagen (β-CTX); Osteoporosis; Procollagen type I N-propeptide (PINP); Tartrate-resistant acid phosphatase 5b (TRACP-5b)

Abstract :

[en] Bone turnover markers (BTMs) are released during the bone remodelling cycle and are measurable in blood or urine, reflecting bone remodelling rate. They have been useful in elucidating the pharmacodynamics and effectiveness of osteoporosis medication in clinical trials and are increasingly used in routine clinical management of osteoporosis, especially for monitoring therapy, in addition to their use in other metabolic bone disease such as Paget's disease of bone and osteomalacia. Serum β isomerised C-terminal telopeptide of type I collagen and pro-collagen I N-terminal propeptide have been designated as reference BTMs for use in osteoporosis. In addition, bone-specific isoenzyme of alkaline phosphatase (B-ALP) secreted by osteoblasts and tartrate-resistant acid phosphatase 5b (TRACP-5b) secreted by osteoclasts are also found to be specific markers of bone formation and resorption, respectively. The concentrations of the latter enzymes in blood measured by immunoassay provide reliable measures of bone turnover even in the presence of renal failure. B-ALP is recommended for use in the assessment of renal bone disease of chronic kidney disease, and TRACP-5b shows promise as a marker of bone resorption in that condition. BTMs in blood do not suffer from biological variation to the same extent as the older BTMs that were measured in urine. Appropriate patient preparation and sample handling are important in obtaining accurate measures of BTMs for clinical use. Reference change values and treatment targets have been determined for the reference BTMs for their use in monitoring osteoporosis treatment. Further ongoing studies will enhance their clinical applications.

Disciplines :

Laboratory medicine & medical technology

Author, co-author :

Vasikaran, Samuel D.

Miura, Masakazu

Pikner, Richard

Bhattoa, Harjit P.

Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale

Language :

English

Title :

Practical Considerations for the Clinical Application of Bone Turnover Markers in Osteoporosis.

Publication date :

February 2023

Journal title :

Calcified Tissue International

ISSN :

0171-967X

eISSN :

1432-0827

Publisher :

Springer, Germany

Volume :

112

Issue :

Pages :

148-157

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 31 December 2021

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