DIAGNOSIS OF ENDOCRINE DISEASE: Bone turnover markers: are they clinically useful?

DIAGNOSIS OF ENDOCRINE DISEASE: Bone turnover markers: are they clinically useful?

Bone turnover markers (BTMs) are useful in clinical practice as they are inexpensive, and they have proven useful for treatment monitoring and identification of poor adherence. BTMs cannot be used in individual patients for identifying accelerated bone loss or an increase in fracture risk or in deci...

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Bibliographic Details
Published in:European journal of endocrinology Vol. 178; no. 1; pp. R19 - R31
Main Authors: Eastell, Richard, Pigott, Tom, Gossiel, Fatma, Naylor, Kim E, Walsh, Jennifer S, Peel, Nicola F A
Format: Journal Article
Language:English
Published: England Bioscientifica Ltd 01-01-2018
Oxford University Press
Subjects:
Biomarkers - metabolism
Bone Density - physiology
Bone loss
Bone Remodeling - physiology
Bone Resorption - diagnosis
Bone Resorption - metabolism
Bone turnover
Clinical medicine
Endocrine System Diseases - diagnosis
Endocrine System Diseases - metabolism
Humans
Osteocalcin - metabolism
Osteoporosis
Peptide Fragments - metabolism
Procollagen - metabolism
Review
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Summary:Bone turnover markers (BTMs) are useful in clinical practice as they are inexpensive, and they have proven useful for treatment monitoring and identification of poor adherence. BTMs cannot be used in individual patients for identifying accelerated bone loss or an increase in fracture risk or in deciding on the optimal therapy. They are useful for monitoring both anti-resorptive and anabolic treatment. Response can be defined as a result that exceeds an absolute target, or by a change greater than the least significant change; if such a response is not present, then poor compliance or secondary osteoporosis are likely causes. A baseline BTM measurement is not always made; in that case, a value of BTM on anti-resorptive treatment that is low or low normal or above the reference interval for anabolic therapy may be taken to indicate a satisfactory response. We provide an approach to using these bone turnover markers in clinical practice by describing algorithms for anti-resorptive and anabolic therapy and describing the changes we observe in the clinical practice setting.
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ISSN:0804-4643
1479-683X
DOI:10.1530/EJE-17-0585