Bone Markers Throughout Sexual Development: Epidemiological Significance and Population-Based Findings

  • Raquel LucasEmail author
  • Ana MartinsEmail author
  • Teresa MonjardinoEmail author
  • Joana Caetano-LopesEmail author
  • João Eurico FonsecaEmail author
Reference work entry
Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)


Bone markers are used in adults to predict fracture risk and to monitor anabolic or catabolic therapies. Much less is known about their usefulness during childhood and adolescence when, besides remodeling, bone markers also reflect modeling and linear growth of the skeleton. Adolescence is a sensitive period for bone health during which a substantial proportion of bone mass is accrued. Therefore, it is important to understand the significance of bone markers at this stage, mainly in identifying individuals at increased risk of bone fragility. Sections of this chapter focus on the trajectories of bone markers during sexual development, as well as their normative values, determinants, and clinical significance. In general, both resorption and formation markers peak at puberty, decreasing from this point onward. In girls, peak metabolism rate occurs earlier and decreases faster than in boys. In both genders, markers are weakly associated with bone physical properties. Few studies have addressed modifiable determinants of bone markers, and the effect of behaviors on bone metabolism is far from consensual. Some successful attempts have been made to use bone markers in the clinical setting to diagnose and monitor pediatric diseases. Today, even though the measurement of bone markers in children and adolescents can be useful in the clinical setting, lack of standardized methods for determination still limits their widespread use.


Bone markers Remodeling Modeling Growth Sexual development Adolescent Bone density Fracture Cohort studies 

List of Abbreviations


Bone-specific alkaline phosphatase


Bone mineral content


Bone mineral density


Cross-linked C-terminal telopeptide of type I collagen


Dual-energy X-ray absorptiometry


Electrochemiluminescence immunoassay


Enzyme-linked immunosorbent assay

EPITeen study

Epidemiological Health Investigation of Teenagers in Porto


Immunochemiluminometric assay


C-Terminal cross-linking telopeptide of type I collagen


Immunoradiometric assay


Cross-linked N-terminal telopeptide of type I collagen






Peak bone mass


Procollagen type I carboxy terminal propeptide


Procollagen type I amino terminal propeptide


Receptor activator of nuclear factor kB


Receptor activator of nuclear factor kB ligand




Tartrate-resistant acid phosphatase



The authors would like to acknowledge Henrique Barros and Elisabete Ramos (ISPUP, Portugal) for the scientific coordination of the EPITeen cohort study and Isabel Maia for her contribution to this chapter.


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© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.EPIUnit - Institute of Public Health of the University of PortoPortoPortugal
  2. 2.Department of Clinical Epidemiology, Predictive Medicine and Public HealthUniversity of Porto Medical SchoolPortoPortugal
  3. 3.Rheumatology Research Unit, Instituto de Medicina MolecularFaculdade de Medicina da Universidade de LisboaLisbonPortugal
  4. 4.Rheumatology DepartmentLisbon Academic Medical CenterLisbonPortugal

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