Bone markers: Their nature and clinical use

• Main Author: Theis Manfred
• Format: Article
• Language: English
• Published: Society of Medical Biochemists of Serbia, Belgrade 2008-01-01
• Series: Journal of Medical Biochemistry
• Subjects: bone markers; bone metabolism; osteoporosis
• Online Access: https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2008/1452-82580802117T.pdf
• ISSN: 1452-8258; 1452-8266

Bone remodeling units are the centerpiece of bone metabolism. They are fueled by a synchronized and well balanced interaction of osteoclasts and osteoblasts, the activity of which releases specific substances known as bone markers into the blood. Resorption markers result from osteoclastic activity, formation markers from osteoblastic activity, and turnover markers from both cell types. In clinical practice, bone markers are today widely used for monitoring of antiresorptive therapy and patient compliance. There is strong evidence that they are also useful for risk assessment with respect to osteoporosis, here complementing established imaging methods. Other possible and partly not yet investigated indications include monitoring of side-effects of certain therapeutic drugs and oncology. In particular the combination of resorption and formation markers may open up a more differentiated insight into the metabolic situation of a patient's bone. The activity of osteoclasts and osteoblasts is triggered and modulated by numerous factors, some of which are of endocrine nature. Easily measurable in today's laboratory are for instance PTH, calcitonin and vitamin D. While calcitonin is not widely used in osteology, PTH and vitamin D define risk factors for an accelerated loss of bone and impaired mineralization of osteoid with the related diseases of osteoporosis, ricketts and osteomalacia. Recent developments in lab diagnosis of bone diseases focus on rheumatic diseases like rheumatoid arthritis, where anti-CCP is a much more specific marker than the common rheuma factors.