Clinical use of biochemical markers of bone remodeling: Current status and future directions

被引:177
作者
Looker, AC
Bauer, DC
Chesnut, CH
Gundberg, CM
Hochberg, MC
Klee, G
Kleerekoper, M
Watts, NB
Bell, NH
机构
[1] Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA
[2] Natl Osteoporosis Fdn, Washington, DC USA
[3] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[4] Univ Washington, Osteoporosis Res Grp, Seattle, WA 98195 USA
[5] Yale Univ, Dept Orthoped, New Haven, CT USA
[6] Univ Maryland, Sch Med, Dept Med, Baltimore, MD 21201 USA
[7] Mayo Clin & Mayo Fdn, Dept Lab Med & Pathol, Rochester, MN 55905 USA
[8] Wayne State Univ, Dept Internal Med, Detroit, MI 48202 USA
[9] Emory Univ, Dept Med, Atlanta, GA 30322 USA
[10] Vet Adm Med Ctr, Charleston, SC 29425 USA
[11] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA
关键词
bone turnover markers; clinical management; osteoporosis;
D O I
10.1007/s001980070088
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Biochemical markers of bone turnover provide a means of evaluating skeletal dynamics that complements static measurements of bone mineral density (BMD). This review evaluates the use of commercially available bone turnover markers as aids in diagnosis and monitoring response to treatment in patients with osteoporosis. High within-person variability complicates but does not preclude their use. Elevated bone resorption markers appear to be associated with increased fracture risk in elderly women, but there is less evidence of a relationship between bone formation markers and fracture risk. The critical question of predicting fracture efficacy with treatment has not been answered. Changes in bone markers as currently determined do not predict BMD response to either bisphosphonates or hormone replacement therapy. Single measurements of markers do not predict BMD cross-sectionally (except possibly in the very elderly), or change in BMD in individual patients, either treated or untreated. On the other hand, research applications of bone turnover markers are of value in investigating the pathogenesis and treatment of bone diseases. Markers have potential in the clinical management of osteoporosis, but their use in this regard is not established. Additional studies with fracture endpoints and information on negative and positive predictive value are needed to evaluate fully the utility of bone turnover markers in individual patients.
引用
收藏
页码:467 / 480
页数:14
相关论文
共 120 条
[61]  
2-U
[62]   A randomized controlled trial to compare the efficacy of cyclical parathyroid hormone versus cyclical parathyroid hormone and sequential calcitonin to improve bone mass in postmenopausal women with osteoporosis [J].
Hodsman, AB ;
Fraher, LJ ;
Watson, PH ;
Ostbye, T ;
Stitt, LW ;
Adachi, JD ;
Taves, DH ;
Drost, D .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (02) :620-628
[63]   Age, menopause, bone turnover markers and lumbar bone loss in healthy Japanese women [J].
Iki, M ;
Kajita, E ;
Dohi, Y ;
Nishino, H ;
Kusaka, Y ;
Tsuchida, C ;
Yamamoto, K ;
Ishii, Y .
MATURITAS, 1996, 25 (01) :59-67
[64]   ESTIMATING AN INDIVIDUALS TRUE CHOLESTEROL LEVEL AND RESPONSE TO INTERVENTION [J].
IRWIG, L ;
GLASZIOU, P ;
WILSON, A ;
MACASKILL, P .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 266 (12) :1678-1685
[65]  
Jensen JEB, 1997, SCAND J CLIN LAB INV, V57, P29
[66]   BIOLOGICAL VARIATION OF BIOCHEMICAL BONE MARKERS [J].
JENSEN, JEB ;
SORENSEN, HA ;
KOLLERUP, G ;
JENSEN, LB ;
SORENSEN, OH .
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, 1994, 54 :36-39
[67]   Can biochemical markers predict bone loss at the hip and spine?: A 4-year prospective study of 141 early postmenopausal women [J].
Keen, RW ;
Nguyen, T ;
Sobnack, R ;
Perry, LA ;
Thompson, PW ;
Spector, TD .
OSTEOPOROSIS INTERNATIONAL, 1996, 6 (05) :399-406
[68]   Bone mineral density and biochemical markers of bone turnover in healthy elderly men and women [J].
Krall, EA ;
DawsonHughes, B ;
Hirst, K ;
Gallagher, JC ;
Sherman, SS ;
Dalsky, G .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 1997, 52 (02) :M61-M67
[69]  
Machado ABD, 1999, J BONE MINER RES, V14, P602
[70]   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].
Marcus, R ;
Holloway, L ;
Wells, B ;
Greendale, G ;
James, MK ;
Wasilauskas, C ;
Kelaghan, J .
JOURNAL OF BONE AND MINERAL RESEARCH, 1999, 14 (09) :1583-1595