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
9 - Bone turnover markers in clinical practice
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
Bone turnover markers are an established tool in the diagnosis and treatment of metabolic bone disease such as Paget's disease of bone. The measurements for these markers have improved considerably in the last few years such that their use can be considered for patients with osteoporosis. In this chapter, we will review the most recent evidence for using bone turnover markers in clinical practice, and give recommendations where they may prove helpful in the management of osteoporosis.
The markers currently in use in clinical practice are serum osteocalcin, serum bone alkaline phosphatase (BAP), urinary N-terminal telopeptide of type 1 collagen (NTx), urinary C-terminal telopeptide of type 1 collagen (CTx) and free deoxypyridinoline (Dpd). The introduction of automated analysers for these markers means that the assays can be performed reliably and should be available in any clinical chemistry laboratory.
Osteocalcin
Osteocalcin is the most abundant noncollagenous protein in bone. It has a high affinity for hydroxyapatite and its formation is vitamin K dependent. The serum sample should be separated and transported to the laboratory within 2 hours, but measurement of the intact and large N-terminal midfragment improves the stability of this marker [1].
Serum bone alkaline phosphatase
Bone alkaline phosphatase has a molecular weight of approximately 140 000 Dal and is found in the membrane of osteoblasts. It is released into the circulation during bone formation. This marker is very stable and is not affected by haemolysis.
- Type
- Chapter
- Information
- Biomarkers of DiseaseAn Evidence-Based Approach, pp. 99 - 114Publisher: Cambridge University PressPrint publication year: 2002