Advances in Clinical Application of Bone Mineral Density and Bone Turnover Markers

Abstract

Bone mineral density is the main basis for the diagnosis of osteoporosis. The measurement methods of bone mineral density include dual X-ray absorptiometry (DXA), quantitative computer tomography (QCT), quantitative ultrasound (QUS), magnetic resonance imaging (MRI) and so on. Currently, bone mineral density measured by dual-energy X-ray absorptiometry (DXA) is the gold standard for the diagnosis of osteoporosis. Bone turnover markers (BTMs) are biochemical products that reflect the activity of bone cells and the metabolic level of bone matrix, and they reflect the dynamic changes of bone tissue in the whole body earlier than bone mineral-density, procollagen type 1 N-terminal propeptide (PINP) and carboxy-terminal cross-linked telopeptide of type 1 collagen (CTX) is sensitive BTMs, widely used in clinical practice, and can predict the occurrence of fractures. Some new markers such as Periostin, AGEs/RAGE, Gelsolin, and Annexin A2 provide new clues for exploring the mechanism of osteoporosis. The combination of the two can better carry out the diagnosis and differential diagnosis of multiple metabolic bone diseases, evaluate the therapeutic response of anti-osteoporotic medicines, and predict fracture risk.