Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis

被引：87

作者：

Lorentzon, Mattias ^{[1
,2
,3
]}

Branco, Jaime ^{[4
,5
]}

Brandi, Maria Luisa ^{[6
]}

Bruyere, Olivier ^{[7
]}

Chapurlat, Roland ^{[8
]}

Cooper, Cyrus ^{[9
,10
,11
,12
,13
]}

Cortet, Bernard ^{[14
,15
,16
]}

Diez-Perez, Adolfo ^{[17
,18
]}

Ferrari, Serge ^{[19
,20
]}

Gasparik, Andrea ^{[21
]}

Herrmann, Markus ^{[22
]}

Jorgensen, Niklas Rye ^{[23
,24
]}

Kanis, John ^{[3
,25
]}

Kaufman, Jean-Marc ^{[26
]}

Laslop, Andrea ^{[27
]}

Locquet, Medea ^{[28
,29
]}

Matijevic, Radmila ^{[30
,31
]}

McCloskey, Eugene ^{[32
]}

Minisola, Salvatore ^{[33
]}

Pikner, Richard ^{[34
,35
,36
]}

Reginster, Jean-Yves ^{[37
,38
]}

Rizzoli, Rene ^{[19
,20
]}

Szulc, Pawel ^{[8
]}

Vlaskovska, Mila ^{[39
]}

Cavalier, Etienne ^{[40
]}

机构：

[1] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Geriatr Med,Dept Internal Med & Clin Nutr, Gothenburg, Sweden

[2] Sahlgrens Univ Hosp, Geriatr Med Clin, Reg Vastra Gotaland, Gothenburg, Sweden

[3] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Melbourne, Vic, Australia

[4] NOVA Univ Lisbon, Med Sci Fac, NOVA Med Sch, CEDOC, Lisbon, Portugal

[5] CHLO, Egas Moniz Hosp, Rheumatol Dept, Lisbon, Portugal

[6] Univ Florence, FirmoLab Fdn FIRMO, Florence, Italy

[7] Univ Liege, Dept Publ Hlth Epidemiol & Hlth Econ, WHO Collaborating Ctr Publ Heath Aspects Musculos, Liege, Belgium

[8] Univ Lyon, Hop E Herriot, INSERM, UMR 1033, F-69437 Lyon 03, France

[9] Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton, Hants, England

[10] Univ Southampton, NIHR Southampton Biomed Res Ctr, Southampton, Hants, England

[11] Univ Hosp Southampton, Southampton, Hants, England

[12] NHS Fdn Trust, Southampton, Hants, England

[13] Univ Oxford, NIHR Oxford Biomed Res Ctr, Oxford, England

[14] CHU Lille, Dept Rheumatol, F-59000 Lille, France

[15] CHU Lille, EA 44090, F-59000 Lille, France

[16] Univ Lille, F-59000 Lille, France

[17] Autonomous Univ Barcelona, Hosp del Mar, Inst Med Invest, Madrid, Spain

[18] Biomed Res Network Frailty & Healthy Aging CIBERF, Madrid, Spain

[19] Geneva Univ Hosp, Serv Bone Dis, CH-1211 Geneva 14, Switzerland

[20] Fac Med, CH-1211 Geneva 14, Switzerland

[21] Univ Med Pharm Sci & Technol Targu Mures, Dept Publ Hlth & Hlth Management, Targu Mures, Romania

[22] Med Univ Graz, Clin Inst Med & Chem Lab Diagnost, Graz, Austria

[23] Copenhagen Univ Hosp, Rigshosp, Dept Clin Biochem, Copenhagen, Denmark

[24] Univ Southern Denmark, Inst Clin Res, Odense Univ Hosp, OPEN,Odense Patient Data Explorat Network, Odense, Denmark

[25] Univ Sheffield, Med Sch, Ctr Metab Bone Dis, Sheffield, S Yorkshire, England

[26] Ghent Univ Hosp, Dept Endocrinol, B-9000 Ghent, Belgium

[27] Austrian Agcy Hlth & Food Safety, Fed Off Safety Hlth Care, Sci Off, Vienna, Austria

[28] Univ Liege, Dept Publ Hlth Epidemiol & Hlth Econ, Liege, Belgium

[29] Belgium WHO Collaborating Ctr Publ Hlth Aspects M, Liege, Belgium

[30] Univ Novi Sad, Fac Med, Novi Sad, Serbia

[31] Clin Orthoped Surg, Clin Ctr Vojvodina, Novi Sad, Serbia

[32] Univ Sheffield, Ctr Integrated Res Musculoskeletal Ageing, Dept Oncol & Metab, Sheffield, S Yorkshire, England

[33] Rome Univ, Dept Internal Med & Med Disciplines, Sapienza, Italy

[34] Klatovska Hosp, Dept Clin Biochem & Bone Metab, Klatovy, Czech Republic

[35] Charles Univ Prague, Fac Med Pilsen, Dept Clin Biochem & Heamathol, Plzen, Czech Republic

[36] Univ West Bohemia, Fac Hlth Care Studies, Plzen, Czech Republic

[37] Univ Liege, WHO Collaborating Ctr Publ Hlth Aspects Musculosk, Liege, Belgium

[38] King Saud Univ, Coll Sci, Biochem Dept, Chair Biomarkers Chron Dis, Riyadh, Saudi Arabia

[39] Med Univ Sofia, Med Fac, Dept Pharmacol, 2 Zdrave Str, Sofia 1431, Bulgaria

[40] Univ Liege, CHU Liege, Liege, Belgium

来源：

ADVANCES IN THERAPY | 2019年 / 36卷 / 10期

关键词：

Algorithm; Bone; Bone biomarker; CTX; Osteoporosis; P1NP; Rheumatology; POSTMENOPAUSAL WOMEN; FRACTURE RISK; DOUBLE-BLIND; INTERNATIONAL OSTEOPOROSIS; VERTEBRAL FRACTURES; METABOLISM MARKERS; RANDOMIZED-TRIAL; DENOSUMAB; TERIPARATIDE; RISEDRONATE;

D O I：

10.1007/s12325-019-01063-9

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Introduction Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. Methods A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Results Serum bone formation marker PINP and resorption marker beta CTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of beta CTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and beta CTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. Conclusion In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy.

引用

页码：2811 / 2824

页数：14