Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Assessing and utilizing the diagnostic or prognostic power of biomarkers
- Part 2 Biomarkers of kidney disease and dysfunction
- Part 3 Biomarkers of bone disease and dysfunction
- 9 Bone turnover markers in clinical practice
- 10 Biomarkers of bone formation
- 11 Biochemical markers of bone resorption
- 12 The clinical application of biomarkers in osteoporosis
- 13 Sources of preanalytical variability in the measurement of biochemical markers of bone turnover
- 14 Genetic approaches to the study of complex diseases: osteoporosis
- Part 4 Biomarkers of liver disease and dysfunction
- Part 5 Biomarkers of gastrointestinal disease and dysfunction
- Part 6 Biomarkers in toxicology
- Part 7 Biomarkers of cardiovascular disease and dysfunction
- Part 8 Biomarkers of neurological disease and dysfunction
- Part 9 Biomarkers in transplantation
- Index
11 - Biochemical markers of bone resorption
Published online by Cambridge University Press: 20 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Assessing and utilizing the diagnostic or prognostic power of biomarkers
- Part 2 Biomarkers of kidney disease and dysfunction
- Part 3 Biomarkers of bone disease and dysfunction
- 9 Bone turnover markers in clinical practice
- 10 Biomarkers of bone formation
- 11 Biochemical markers of bone resorption
- 12 The clinical application of biomarkers in osteoporosis
- 13 Sources of preanalytical variability in the measurement of biochemical markers of bone turnover
- 14 Genetic approaches to the study of complex diseases: osteoporosis
- Part 4 Biomarkers of liver disease and dysfunction
- Part 5 Biomarkers of gastrointestinal disease and dysfunction
- Part 6 Biomarkers in toxicology
- Part 7 Biomarkers of cardiovascular disease and dysfunction
- Part 8 Biomarkers of neurological disease and dysfunction
- Part 9 Biomarkers in transplantation
- Index
Summary
Introduction
The majority of biochemical markers of bone resorption are based on the measurement of fragments of collagen type I, the fibrillar component which constitutes over 90% of the protein in bone. Other resorption marker assays that are based either on noncollagenous proteins or specific enzyme activities have received more attention since they are available as serum assays and, until recently, most bone resorption markers were those available as urine assays. The aim of this chapter is to give an account of the recent progress in the development of bone markers, with particular emphasis on the biochemical basis for each assay, along with a review of the criteria necessary for properly interpreting the results.
Before 1990, the principal method available clinically for the assessment of bone resorption was urinary hydroxyproline. It was recognized, however, at the time that this method lacked specificity and sensitivity for a number of reasons. In addition to its known release from dietary sources, a major problem with measuring hydroxyproline is the presence of this amino acid in all connective tissues as well as some rapidly metabolized serum components such as C1q. A second major drawback with urinary hydroxyproline was the fact that this assay measures not only the degradation of insoluble tissue collagen but also the release of hydroxyproline from biosynthetic intermediates including degradation of precursors intracellularly, a process which could account for more than 15% of the total collagen synthesized.
- Type
- Chapter
- Information
- Biomarkers of DiseaseAn Evidence-Based Approach, pp. 122 - 132Publisher: Cambridge University PressPrint publication year: 2002