The dawn of bone turnover markers in the management of osteoporosis

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The dawn of bone turnover markers in the management of osteoporosis

Bone goes through a constant remodeling throughout the life span and thus, it is a dynamic tissue. In continuous remodelling of bone, bone turnover is balanced with coupling of bone formation and resorption at various rates. Hence, a study of bone turnover markers (BTMs) renders an insight of the dynamics of bone turnover in many metabolic bone disorders.

An escalation in bone turnover  seen with aging and pathological states like osteoporosis, that indicates a deterioration of the bone microarchitecture, thereby increasing the risk of fracture, independent of low bone mineral density (BMD). Moreover, BTMs can be used to assess these microarchitectural alterations affecting the bone quality and so, may serve as a complementary tool to BMD in the evaluation of fracture risk.

The current review considered a systematic search of literature regarding BTMs using the PubMed database. For the management of osteoporosis, many reliable, rapid, and cost-effective automated assays of BTMs with good sensitivity are available. Nevertheless, BTMs are subjected to various pre-analytical and analytical variations necessitating the strict sample collection and assays methods plus utilizing ethnicity-based reference standards for distinct populations. The most important applications of measuring BTMs are the assessment of fracture risk and monitoring the adherence and response to therapy, which is a challenge in a chronic, asymptomatic disease.  This review explained the physiology of bone remodeling, various conventional and novel BTMs, and BTM assays and their role in the assessment of fracture risk and also  monitoring response to treatment with antiresorptive or anabolic agents.

Source:

Indian J Endocrinol Metab. 2016 Nov-Dec; 20(6): 846–852

Link to the source:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105571/

Original title of article:

Bone turnover markers: Emerging tool in the management of osteoporosis

Authors:

Sahana Shetty et al.

Indian J Endocrinol Metab. 2016 Nov-Dec; 20(6): 846–852
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