Practical Considerations for the Clinical Application of Bone Turnover Markers in Osteoporosis

Vasikaran, Samuel; Miura, Masaru; Pikner, Richard; Bhattoa, Harjit Pal; Cavalier, Étienne

doi:10.1007/s00223-021-00930-4

Cited by 36 publications

(34 citation statements)

References 63 publications

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“…The serum level of BTMs can dynamically reflect the bone metabolism and detect bone loss timely. It is clinically used to monitor the progression of osteoporosis and the efficacy of anti-osteoporotic drugs [ 5 , 11 ]. Thus, BTMs can also be used to assess changes in bone mass during and after critical illness.…”

Section: Methodsmentioning

confidence: 99%

Critical illness and bone metabolism: where are we now and what is next?

2022

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Critical illness refers to the clinical signs of severe, variable and life-threatening critical conditions, often accompanied by insufficiency or failure of one or more organs. Bone health of critically ill patients is severely affected during and after ICU admission. Therefore, clinical work should focus on ICU-related bone loss, and early development and implementation of related prevention and treatment strategies: optimized and personalized nutritional support (high-quality protein, trace elements and intestinal prebiotics) and appropriate physiotherapy and muscle training should be implemented as early as possible after ICU admission and discharge. At the same time, the drug regulates excessive metabolism and resists osteoporosis.

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Section: Methodsmentioning

confidence: 99%

Critical illness and bone metabolism: where are we now and what is next?

2022

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“…Intermethod or intermanufacturer variability is uniformly high, mainly related to problems of antibody specificity and standardization, and automated methods are only available for a subset of BTMs. Lastly, most BTMs show substantial biological variability [17][18][19], although BTMs in blood do not suffer from biological variation to the same extent as the older BTMs that were measured in urine [20].…”

Section: Key Pointsmentioning

confidence: 96%

Clinical utility of bone turnover markers in patients with chronic kidney disease

Smout

Jørgensen

Cavalier

et al. 2022

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of reviewThe burden of fractures is very high in patients with chronic kidney disease (CKD). It is increasingly recognized that knowledge of bone turnover is of paramount importance in guiding mineral metabolism and osteoporosis therapy in CKD. Bone histomorphometry is the gold standard to assess bone turnover, but is seldomly performed in clinical practice. Bone turnover markers (BTMs) may be the long awaited noninvasive diagnostic that may help to close the therapeutic gap in patients with advanced CKD presenting with bone fragility. Recent findingsMounting evidence indicates that BTMs may be useful in skeletal and nonskeletal risk stratification, in guiding mineral metabolism and osteoporosis therapy, and in monitoring the therapeutic response.

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“…When evaluating disorders of mineralization, a key analyte to be determined is ALP, in order to make diagnosis, estimate disease severity, and monitor the effect of therapy [ 35 ]. ALP is the serological marker of overt osteomalacia, especially when it is persistently elevated.…”

Section: Biochemical Features and Differential Diagnosismentioning

confidence: 99%

Osteomalacia Is Not a Single Disease

Cianferotti

2022

IJMS

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Among bone-material qualities, mineralization is pivotal in conferring stiffness and toughness to the bone. Osteomalacia, a disease ensuing from inadequate mineralization of the skeleton, is caused by different processes leading to decreased available mineral (calcium and/or phosphate) or enzymatic alterations. Vitamin D deficiency, which remains the major cause of altered mineralization leading to inadequate intestinal calcium and phosphate absorption, may be also associated with other conditions primarily responsible for abnormal mineralization. Given the reality of widespread vitamin D inadequacy, a full biochemical assessment of mineral metabolism is always necessary to rule out or confirm other conditions. Both too-high or too-low serum alkaline phosphatase (ALP) levels are important for diagnosis. Osteomalacic syndrome is reversible, at least in part, by specific treatment. Osteomalacia and bone mineralization themselves constitute largely unexplored fields of research. The true prevalence of the different forms of osteomalacia and the recovery after proper therapy have yet to be determined in the real world. Although non-invasive techniques to assess bone mineralization are not available in clinical practice, the systematic assessment of bone quality could help in refining the diagnosis and guiding the treatment. This review summarizes what is known of osteomalacia recent therapeutic developments and highlights the future issues of research in this field.

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Practical Considerations for the Clinical Application of Bone Turnover Markers in Osteoporosis

Cited by 36 publications

References 63 publications

Critical illness and bone metabolism: where are we now and what is next?

Critical illness and bone metabolism: where are we now and what is next?

Clinical utility of bone turnover markers in patients with chronic kidney disease

Osteomalacia Is Not a Single Disease

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