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Bone Turnover Markers Show The Big Picture


 

SAN DIEGO — A chief advantage of assessing bone turnover markers such as serum osteocalcin and urine hydroxyproline in osteoporosis patients is that they provide an integrated assessment of skeletal metabolism, Dr. Marc C. Hochberg said at the annual meeting of the International Society for Clinical Densitometry.

Other advantages of using these markers include the following:

▸ The markers show rapid and large changes with therapy.

▸ Automated assays are widely available, and they're less expensive than dual-energy x-ray absorptiometry, although more expensive than ultrasound.

▸ High turnover is associated with fracture risk, independent of bone mineral density.

However, “as with everything, there are advantages and limitations” to bone turnover markers, said Dr. Hochberg, head of the division of rheumatology and clinical immunology at the University of Maryland, Baltimore.

For example, some bone markers reflect both bone formation and bone resorption. Also, “most of the markers are present in tissues other than bone and may be influenced by nonskeletal processes,” he said. Further, changes in bone turnover markers are not disease specific, and measurement of the markers varies.

Doug Brunk

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