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Bone Turnover Markers

Their Place in the Investigation of Osteoporosis

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Osteoporosis

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Bone turnover markers have been used in medicine for over 70 yr and have proven indispensable in metabolic bone disorders such as Paget’s disease of bone. The perturbations in bone turnover in osteoporosis are small and early markers that are not specific to bone were not very useful in evaluating the disease. However, marker measures have recently been introduced that are more specific for bone. In this chapter, we will consider the approaches for the use of these markers in the evaluation of osteoporosis.

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References

  1. Hannon R, Eastell R. Preanalytical variability of biochemical markers of bone turnover. Osteoporosis Int2000; 6: S30 - 44.

    Google Scholar 

  2. Khosla S, Melton LJ, III, Atkinson EJ, O’Fallon WM, Klee GG, Riggs BL. Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab 1998; 83 (7): 2266 - 2274.

    Article  PubMed  CAS  Google Scholar 

  3. Bauer DC, Sklarin PM, Stone KL, Black DM, Nevitt MC, Ensrud KE, et al. Biochemical markers of bone turnover and prediction of hip bone loss in older women: the study of osteoporotic fractures. J Bone Miner Res 1999; 14 (8): 1404 - 1410.

    Article  PubMed  CAS  Google Scholar 

  4. Garnero P, Sornay-Rendu E, Duboeuf F, Delmas PD. Markers of bone turnover predict postmenopausal forearm bone loss over 4 years: the OFELY study. J Bone Miner Res 1999; 14 (9): 1614 - 1621.

    Article  PubMed  CAS  Google Scholar 

  5. Marcus R, Holloway L, Wells B, Greendale G, James MK, Wasilauskas C, et al. 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 1999; 14 (9): 1583 - 1595.

    Article  PubMed  CAS  Google Scholar 

  6. Rogers A, Hannon R, Eastell R. Biochemical markers as predictors of rates of bone loss after menopause. J Bone Miner Res 2000; 15 [7]: 1398 - 1404

    Article  PubMed  CAS  Google Scholar 

  7. Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res 2000; 15 [8]: 1526 - 1536

    Article  PubMed  CAS  Google Scholar 

  8. Garnero P, Hausherr E, Chapuy MC, Marcelli C, Grandjean H, Muller C, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Miner Res 1996; 11 (10): 1531 - 1538.

    Article  PubMed  CAS  Google Scholar 

  9. van Daele PL, Seibel MJ, Burger H, Hofman A, Grobbee DE, van Leeuwen JP, et al. Case-control analysis of bone resorption markers, disability, and hip fracture risk: the Rotterdam study. BMJ 1996; 312 (7029): 482 - 483.

    Article  PubMed  Google Scholar 

  10. Akesson K, Ljunghall S, Jonsson B, Sernbo I, Johnell O, Gardsell P, et al. Assessment of biochemical markers of bone metabolism in relation to the occurrence of fracture: a retrospective and prospective population-based study of women. J Bone Miner Res 1995; 10 (11): 1823 - 1829.

    Article  PubMed  CAS  Google Scholar 

  11. Ross PD, Kress BC, Parson RE, Wasnich RD, Armour KA, Mizrahi IA. Serum bone alkaline phosphatase and calcaneus bone density predict fractures: a prospective study. Osteoporosis Int 2000; 11 (1): 76 - 82.

    Article  CAS  Google Scholar 

  12. Riggs BL, Melton LJ, III, O’Fallon WM. Drug therapy for vertebral fractures in osteoporosis: evidence that decreases in bone turnover and increases in bone mass both determine antifracture efficacy. [Review] [26 refs]. Bone 1996; 18 (3 Suppl): 197S - 201S.

    Article  PubMed  CAS  Google Scholar 

  13. Garnero P, Dargent-Molina P, Hans D, Schott AM, Breart G, Meunier Pi, et al. Do markers of bone resorption add to bone mineral density and ultrasonographic heel measurement for the prediction of hip fracture in elderly women? The EPIDOS prospective study. Osteoporosis Int 1998; 8 (6): 563 - 569.

    Google Scholar 

  14. Garnero P, Sornay-Rendu E, Chapuy MC, Delmas PD. Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 1996; 11 (3): 337 - 349.

    Article  PubMed  CAS  Google Scholar 

  15. Eastell R, Robins SP, Colwell T, Assiri AM, Riggs BL, Russell RG. Evaluation of bone turnover in type I osteoporosis using biochemical markers specific for both bone formation and bone resorption. Osteoporosis Int 1993; 3 (5): 255 - 260.

    Article  CAS  Google Scholar 

  16. Ravn P, Hosking D, Thompson D, Cizza G, Wasnich RD, McClung M, et al. Monitoring of alendronate treatment and prediction of effect on bone mass by biochemical markers in the early postmenopausal intervention cohort study. J Clin Endocrinol Metab 1999; 84 (7): 2363 - 2368.

    Article  PubMed  CAS  Google Scholar 

  17. Duda RJ, Jr., O’Brien JF, Katzmann JA, Peterson JM, Mann KG, Riggs BL. Concurrent assays of circulating bone Gla-protein and bone alkaline phosphatase: effects of sex, age, and metabolic bone disease. J Clin Endocrinol Metab 1988; 66 (5): 951 - 957.

    Article  PubMed  CAS  Google Scholar 

  18. WoitgeHW, Pecherstorfer M, Li Y, Keck AV, Horn E, Ziegler R, et al. Novel serum markers of bone resorption: clinical assessment and comparison with established urinary indices. J Bone Miner Res 1999; 14 (5): 792 - 801.

    Google Scholar 

  19. Stevenson JC, Cust MP, Gangar KF, Hillard TC, Lees B, Whitehead MI. Effects of transdermal versus oral hormone replacement therapy on bone density in spine and proximal femur in postmenopausal women. Lancet 1990; 336 (8710): 265 - 269.

    Article  PubMed  CAS  Google Scholar 

  20. Koster JC, Hackeng WH, Mulder H. Diminished effect of etidronate in vitamin D deficient osteopenic postmenopausal women. Eur J Clin Pharmacol 1996; 51 (2): 145 - 147.

    Article  PubMed  CAS  Google Scholar 

  21. Cummings SR, Palermo L, Browner W, Marcus R, Wallace R, Pearson J, et al. Monitoring osteoporosis therapy with bone densitometry: misleading changes and regression to the mean. Fracture Intervention Trial Research Group. JAMA 2000; 283 (10): 1318 - 1321.

    Article  PubMed  CAS  Google Scholar 

  22. Eastell R. Assessment of bone density and bone loss. [Review] [6 refs]. Osteoporosis hit 1996;6 Suppl 2: 3 - 5.

    Google Scholar 

  23. Mashiba T, Hirano T, Turner CH, Forwood MR, Johnston CC, Burr DB. Suppressed bone turnover by bisphosphonates increases microdamage accumulation and reduces some biomechanical properties in dog rib. J Bone Miner Res 2000; 15 (4): 613 - 620.

    Article  PubMed  CAS  Google Scholar 

  24. Ingle BM, Hay SM, Bottjer HM, Eastell R. Changes in bone mass and bone turnover following ankle fracture. Osteoporosis Int 1999; 10 (5): 408 - 415.

    Article  CAS  Google Scholar 

  25. Ingle BM, Hay SM, Bottjer HM, Eastell R. Changes in bone mass and bone turnover following distal forearm fracture. Osteoporosis International 1999; 10 (5): 399 - 407.

    Article  PubMed  CAS  Google Scholar 

  26. Hochberg MC, Ross PD, Black D, Cummings SR, Genant HK, Nevitt MC, et al. Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group. Arthritis Rheum 1999; 42 (6): 1246 - 1254.

    Article  PubMed  CAS  Google Scholar 

  27. Ravn P, Christensen JO, Baumann M, Clemmesen B. Changes in biochemical markers and bone mass after withdrawalofibandronatetreatment: prediction ofbone mass changes during treatment. Bone 1998; 22 (5): 559 - 564.

    Article  PubMed  CAS  Google Scholar 

  28. Garnero P, Shih WJ, Gineyts E, Karpf DB, Delmas PD. Comparison of new biochemical markers of bone turnover in late postmenopausal osteoporotic women in response to alendronate treatment. J Clin Endocrinol Metab 1994; 79 (6): 1693 - 1700.

    Article  PubMed  CAS  Google Scholar 

  29. Greenspan SL, Parker RA, Ferguson L, Rosen HN, Maitland-Ramsey L, Karpf, et al. Early changes in biochemical markers of bone turnover predict the long-term response to alendronate therapy in representative elderly women: a randomized clinical trial. J Bone Miner Res 1998; 13 (9): 1431 - 1438.

    Article  PubMed  CAS  Google Scholar 

  30. Rosen CJ, Chesnut CH, III, Mallinak NJ. 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 1997; 82 (6): 1904 - 1910.

    Article  PubMed  CAS  Google Scholar 

  31. Wasnich R, Miller PD. Antifracture efficacy of antiresorptive agents are related to changes in bone density. J Clin Endocrinol Metab 2000; 85 [1]: 231 - 236.

    Article  PubMed  CAS  Google Scholar 

  32. Thiebaud D, Burckhardt P, Kriegbaum H, Huss H, Mulder H, Juttmann JR, et al. Three monthly intravenous injections of ibandronate in the treatment of postmenopausal osteoporosis. Am J Med 1997; 103 (4): 298 - 307.

    Article  PubMed  CAS  Google Scholar 

  33. Braga de Castro MA, Hannon R, Eastell R. Monitoring alendronate therapy for osteoporosis. J Bone Miner Res 1999; 14 (4): 602 - 608.

    Article  Google Scholar 

  34. Chesnut C, III, Silverman S, Andriano K, Genant HK, Gimona A, Harris S, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. Am J Med 2000; 109: 267 - 276.

    Article  PubMed  CAS  Google Scholar 

  35. Delmas PD, Bjarnason NH, Mitlak BH, Ravoux AC, Shah AS, Huster WJ, et al. Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women. N Engl J Med 1997; 337 (23): 1641 - 1647.

    Article  PubMed  CAS  Google Scholar 

  36. Fogelman I, Ribot C, Smith R, Ethgen D, Sod E, Reginster JY. Risedronate reverses bone loss in postmenopausal women with low bone mass: results from a multinational, double-blind, placebo-controlled trial. BMD-MN Study Group. J Clin Endocrinol Metab 2000; 85 (5): 1895 - 1900.

    Article  PubMed  CAS  Google Scholar 

  37. Hannon R, Blumsohn A, Naylor K, Eastell R. Response of biochemical markers of bone turnover to hormone replacement therapy: impact of biological variability [see comments]. J Bone Miner Res 1998; 13 (7): 1124 - 1133.

    Article  PubMed  CAS  Google Scholar 

  38. Lindsay R, Nieves J, Formica C, Henneman E, Woelfert L, Shen V, et al. Randomised controlled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosis. Lancet 1997; 350 (9077): 550 - 555.

    Article  PubMed  CAS  Google Scholar 

  39. Saag KG, Emkey R, Schnitzer TJ, Brown JP, Hawkins F, Goemaere S, et al. Alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis. Glucocorticoid-Induced Osteoporosis Intervention Study Group. N Engl J Med 1998; 339 (5): 292 - 299.

    Article  PubMed  CAS  Google Scholar 

  40. Cohen S, Levy RM, Keller M, Boling E, Emkey RD, Greenwald M, et al. Risedronate therapy prevents corticosteroid-induced bone loss: a twelve-month, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Arthritis Rheum 1999; 42 (11): 2309 - 2318.

    Article  PubMed  CAS  Google Scholar 

  41. Bainbridge PR, Eastell R. The clinical utility of bone turnover markers: nurse monitoring clinic. Arthritis Rheum 1999; 42 [supplement 1]: S388.

    Google Scholar 

  42. Delmas PD, Hardy P, Garnero P, Dain M. Monitoring individual response to hormone replacement therapy with bone markers. Bone 2000; 26 (6): 553 - 560.

    Article  PubMed  CAS  Google Scholar 

  43. Garnero P, Darte C, Delmas PD. A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical marker of bone turnover. Bone 1999; 24 (6): 603 - 609.

    Article  PubMed  CAS  Google Scholar 

  44. Looker A, Bauer DC, Chesnut C, III, Gundberg CM, Hochberg MC, Klee GG, et al. Clinical use of biochemical markers of bone remodeling: current status, future directions. Osteoporosis Int 2000;11[61:467-480.

    Google Scholar 

  45. Delmas PD, Eastell R, Garnero P, et al. The use of biochemical markers of bone turnover in osteoporosis. Osteoporosis Int 2000; 6: S12 - 17.

    Google Scholar 

  46. Bainbridge P, Eastell R. The clinical utility of bone turnover markers: nurse monitoring clinic. Arthritis Rheum 2000; 42 [supplement 1]: S388.

    Google Scholar 

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Authors
  1. Richard Eastell MD
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  2. Penny R. Bainbridge BA
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Editors and Affiliations

  1. Oregon Health & Science University, Portland, OR, USA

    Eric S. Orwoll MD  & Michael Bliziotes MD  & 

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Eastell, R., Bainbridge, P.R. (2003). Bone Turnover Markers. In: Orwoll, E.S., Bliziotes, M. (eds) Osteoporosis. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-278-4_9

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  • DOI: https://doi.org/10.1007/978-1-59259-278-4_9

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-260-5

  • Online ISBN: 978-1-59259-278-4

  • eBook Packages: Springer Book Archive

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