Use of bone turnover markers in postmenopausal osteoporosis

被引:475
|
作者
Eastell, Richard [1 ]
Szulc, Pawel [2 ]
机构
[1] Univ Sheffield, Acad Unit Bone Metab, Sheffield, S Yorkshire, England
[2] Univ Lyon, Hop Edouard Herriot, INSERM, UMR 1033, Lyon, France
来源
LANCET DIABETES & ENDOCRINOLOGY | 2017年 / 5卷 / 11期
关键词
RANDOMIZED CONTROLLED-TRIAL; HEALTHY PREMENOPAUSAL WOMEN; FRACTURE INTERVENTION TRIAL; ZOLEDRONIC ACID TREATMENT; DIETARY CALCIUM INTAKE; URINARY N-TELOPEPTIDE; BIOCHEMICAL MARKERS; MINERAL DENSITY; REFERENCE INTERVALS; ORAL BISPHOSPHONATES;
D O I
10.1016/S2213-8587(17)30184-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bone turnover comprises two processes: the removal of old bone (resorption) and the laying down of new bone (formation). N-terminal propeptide of type I procollagen (PINP) and C-telopeptide of type I collagen (CTX-I) are markers of bone formation and resorption, respectively, that are recommended for clinical use. Bone turnover markers can be measured on several occasions in one individual with good precision. However, these markers are subject to several sources of variability, including feeding (resorption decreases) and recent fracture (all markers increase for several months). Bone turnover markers are not used for diagnosis of osteoporosis and do not improve prediction of bone loss or fracture within an individual. In untreated women, very high bone turnover marker concentrations suggest secondary causes of high bone turnover (eg, bone metastases or multiple myeloma). In people with osteoporosis, bone turnover markers might be useful to assess the response to anabolic and antiresorptive therapies, to assess compliance to therapy, or to indicate possible secondary osteoporosis. Much remains to be learnt about how bone turnover markers can be used to monitor the effect of stopping bisphosphonate therapy (eg, to identify a threshold above which restarting therapy should be considered). More studies are needed to investigate the use of bone turnover markers for assessment of the bone safety of new medications.
引用
收藏
页码:908 / 923
页数:16
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