Biochemical Indices of Bone Turnover

  • Markus J. Seibel


  • The development of new biochemical markers of bone metabolism has greatly enriched the array of analytes used in the assessment of skeletal pathologies. When applied and interpreted correctly, these indices may be useful in the work-up of patients with metabolic or malignant bone disease.

  • Although they are not suitable for establishing the diagnosis of osteoporosis itself, they may, in selected cases, provide additional information on fracture risk.

  • Bone markers may also be used to assess disease activity (e.g, in Paget’s disease of bone) and to monitor therapeutic response and efficacy in patients receiving treatment.

  • One should always bear in mind, however, that (i) abnormalities in molecular markers of bone metabolism are never disease-specific; (ii) most data on the utility of these markers have been obtained from research trials and few attempts have been made to translate the results to the clinical situation facing the individual patient; and (iii) the “real-life” variability of bone markers can be significant and needs consideration before any decision is made on the basis of marker results.


Bone Resorption Fracture Risk Bone Turnover Bone Turnover Marker Bone Marker 
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Further Reading

  1. Seibel MJ, Woitge H, Scheidt-Nave C, et al. (1994) Urinary hydroxypyridinium crosslinks of collagen in population-based screening for overt vertebral osteoporosis: results of a pilot study. J Bone Miner Res 9: 1433–1440.Google Scholar
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  8. Weel AEAM, Seibel MJ, Hofman A, et al. (1999) Which fractures are associated with high bone resorption in elderly women: the Rotterdam study. J Bone Miner Res 14: S160.Google Scholar
  9. Rosen C, Chesnut CH III, Mallinak NJS (1997) The predictive value of biochemical markers of bone turnover for bone mineral density in early postmenopausal women treated with hormone replacement or calcium supplementation. J Clin Endocrinol Metab 82: 1904–1910.PubMedCrossRefGoogle Scholar
  10. Hannon R. Blumsohn A, Naylor K, et al. (1998) Response of biochemical markers of bone turnover to hormone replacement therapy: impact of biological variability. J Bone Miner Res 13: 1124–1133.Google Scholar
  11. Marcus R, Holloway L, Wells B, et al. (1999) The relationship of biochemical markers of bone turnover to bone density changes in postmenopausal women: results from the postmenopausal estrogen/progestin interventions (PEPI) trial. J Bone Miner Res 14: 1583–1595.Google Scholar
  12. Hannon R, Eastell R (2000) Preanalytical variability of biochemical markers of bone turnover. Osteoporos Int 10: S30–44.CrossRefGoogle Scholar

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© Springer-Verlag London 2004

Authors and Affiliations

  • Markus J. Seibel

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