Risk assessment for osteoporosis. II. Biochemical markers of bone turnover: bone resorption indices

This article describes the biochemical background and functional properties of molecular markers derived from osteoblasts, the collagenous, or noncollagenous bone matrix. Clinical applications and the selection, timing, and monitoring of antiosteoporotic treatment are critically discussed. Special emphasis has been put on reviewing the value of bone resorption markers in the prediction of future bone loss and the risk assessment for osteoporotic fractures. The potential of these indices as independent risk factors for future fractures alone or in combination with bone mineral density measurements has recently been demonstrated in large cohort studies. More data are needed, however, to establish biochemical markers of bone resorption as useful tools in the assessment of individual fracture risk.