Clinical Use of Biochemical Markers of Bone Remodeling: Current Status and Future Directions |
| |
| Authors: | A C Looker D C Bauer C H Chesnut III C M Gundberg M C Hochberg G Klee M Kleerekoper N B Watts N H Bell |
| |
| Institution: | (1) National Osteoporosis Foundation, Washington, DC, and National Center for Health Statistics, Hyattsville, MD, US;(2) Department of Medicine, University of California, San Francisco, San Francisco CA, US;(3) Osteoporosis Research Group, University of Washington, Seattle, WA, US;(4) Department of Orthopedics, Yale University, New Haven, CT, US;(5) Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, US;(6) Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Foundation, Rochester, MN, US;(7) Department of Internal Medicine, Wayne State University, Detroit MI, US;(8) Department of Medicine, Emory University, Atlanta, GA;, US;(9) VA Medical Center and Department of Medicine, Medical University of South Carolina, Charleston, SC, USA, US |
| |
| Abstract: | Biochemical markers of bone turnover provide a means of evaluating skeletal dynamics that complements static measurements
of bone mineral density (BMD). This review evaluates the use of commercially available bone turnover markers as aids in diagnosis
and monitoring response to treatment in patients with osteoporosis. High within-person variability complicates but does not
preclude their use. Elevated bone resorption markers appear to be associated with increased fracture risk in elderly women,
but there is less evidence of a relationship between bone formation markers and fracture risk. The critical question of predicting
fracture efficacy with treatment has not been answered. Changes in bone markers as currently determined do not predict BMD
response to either bisphosphonates or hormone replacement therapy. Single measurements of markers do not predict BMD cross-sectionally
(except possibly in the very elderly), or change in BMD in individual patients, either treated or untreated. On the other
hand, research applications of bone turnover markers are of value in investigating the pathogenesis and treatment of bone
diseases. Markers have potential in the clinical management of osteoporosis, but their use in this regard is not established.
Additional studies with fracture endpoints and information on negative and positive predictive value are needed to evaluate
fully the utility of bone turnover markers in individual patients. |
| |
| Keywords: | :Bone turnover markers – Clinical management – Osteoporosis |
| 本文献已被 SpringerLink 等数据库收录！ |
|
