Drugs & Aging

, Volume 12, Supplement 1, pp 9–14 | Cite as

Markers of Bone Remodelling in Metabolic Bone Disease

  • Marie-Christine de Vernejoul
Review Article

Summary

New specific markers of bone remodelling have been developed that allow the evaluation of bone formation (plasma levels of osteocalcin and bone alkaline phosphatases) or bone resorption (collagen crosslink levels in urine). These markers can be used to evaluate bone disease. Their best application is currently in renal osteodystrophy, where there is a broad spectrum of bone abnormalities. In patients with this disease, bone markers can obviate the need for bone biopsy. So far, bone alkaline phosphatase is the most sensitive and specific marker for predicting the type of bone disease and therefore for deciding treatment in dialysed patients, although it is not ideal.

Bone markers have also allowed a dramatic improvement in the comprehensive approach to bone loss with aging in women. Monitoring of the marked increase in bone turnover, and its persistence, in older women after menopause may help in the design of treatment strategies for osteoporosis. There is some hope that the measurement of urinary levels of collagen crosslinks will help to predict the clinical outcome of osteoporosis with respect to fractures in postmenopausal women.

Bone markers could, besides being a measurement of bone density, help to determine the optimal treatment of postmenopausal women. Bone markers could also be used to predict or ascertain the response to treatments of osteoporosis, but few data are currently available to judge the routine usefulness of these new applications.

Keywords

Bone Loss Bone Resorption Adis International Limited Osteocalcin Bone Remodelling 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hercz G, Pei Y, Greenwood C, et al. Aplastic osteodystrophy without aluminum. The role of suppressed parathyroid function. Kidney Int 1993; 44: 860–6PubMedCrossRefGoogle Scholar
  2. 2.
    Urena P, Ferreira A, Kung VT, et al. Serum pyridinoline as a specific marker of collagen breakdown and bone metabolism in hemodialysis patients. J Bone Miner Res 1995; 10(6): 932–9PubMedCrossRefGoogle Scholar
  3. 3.
    Urena P, Hruby M, Ferreira A, et al. Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. J Am Soc Nephrol 1996; 7(3) 506–12PubMedGoogle Scholar
  4. 4.
    Parfitt AM, Mathews CHE, Villanueva AR, et al. Relationships between surface, volume and thickness of iliac trabecular bone in aging and in osteoporosis. J Clin Invest 1983; 72: 1396–409PubMedCrossRefGoogle Scholar
  5. 5.
    Kushida K, Takahashi M, Kawana K, et al. Comparison of markers for bone formation and resorption in premenopausal and postmenopausal subjects and osteoporosis patients. J Clin Endocrinol Metab 1995; 80: 2447–50PubMedCrossRefGoogle Scholar
  6. 6.
    Riis SBJ, Hansen AM, Jensen K, et al. Low bone mass and fast rate of bone loss at menopause: equal risk factors for future fracture: a 15-year follow-up study. Bone 1996; 19(1): 9–12PubMedCrossRefGoogle Scholar
  7. 7.
    Garnero P, Sornay-Rendu E, Chapuy M-C, et al. Increased bone turn-over in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 1996; 11(3): 337–49PubMedCrossRefGoogle Scholar
  8. 8.
    Schneider DL, Barrett-Connor EL. Urinary N-telopeptide levels discriminate normal, osteopenic, and osteoporotic bone mineral density. Arch Intern Med 1997; 157(11): 1241–5PubMedCrossRefGoogle Scholar
  9. 9.
    Keen RW, Nguyen T, Sobnack R, et al. Can biochemical markers predict bone loss at the hip and spine?: a 4-year prospective study of 141 early postmenopausal women. Osteoporos Int 1996; 6: 399–406PubMedCrossRefGoogle Scholar
  10. 10.
    Nguyen TV, Sambrook PN, Eisman JA. Sources of variability in bone mineral density measurements: implications for study design and analysis of bone loss. J Bone Miner Res 1997; 12(1): 124–35PubMedCrossRefGoogle Scholar
  11. 11.
    Cummings SR, Black D, Ensrud K, et al. Urine markers of bone resorption predict hip bone loss and fractures in older women: the study of osteoporotic fractures. J Bone Miner Res 1996; 11Suppl. 1: S128Google Scholar
  12. 12.
    Garnero P, Hausherr E, Chapuy MC, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS prospective study. J Bone Miner Res 1996; 11(10): 1531–8PubMedCrossRefGoogle Scholar
  13. 13.
    Kamel S, Brazier M, Rogez JC, et al. Different responses of free and peptide-bound cross-links to vitamin D and calcium supplementation in elderly women with vitamin D insufficiency. J Clin Endocrinol Metab 1996; 81(10): 3717–21PubMedCrossRefGoogle Scholar
  14. 14.
    Garnero P, Gineyts E, Arbault P, et al. Different effects of bisphosphonate and estrogen therapy on free and peptidebound bone cross-links excretion. J Bone Miner Res 1995; 10(4): 641–9PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • Marie-Christine de Vernejoul
    • 1
  1. 1.Clinique de Rhumatologie and INSERM U349Hôpital LariboisièreParis, cedex 10France

Personalised recommendations