The bone marker plot: an innovative method to assess bone turnover in women

Area of Science:

• Biochemistry
• Orthopedics
• Endocrinology

Background:

• Biochemical markers indicate bone resorption and formation, crucial for skeletal health.
• Current interpretations often overlook the balance between these processes.
• A new graphic report is introduced to visualize both resorption and formation simultaneously.

Purpose of the Study:

• To develop and present a graphic report integrating bone resorption and formation markers.
• To assess bone turnover dynamics in pre-, peri-, and postmenopausal women.
• To provide an intuitive perception of bone turnover balance and rate.

Main Methods:

• Bone turnover markers were measured in 599 women (aged 25-74).
• Reference ranges were established using a subset of 269 women with normal T-scores.
• Marker concentrations were mathematically transformed into plots representing fast/slow resorption and formation, with a 95% confidence ellipse for reference.

Main Results:

• In postmenopausal women, marker plots indicated a shift towards accelerated bone resorption.
• Median levels of bone resorption marker CrossLaps and bone formation markers osteocalcin and aminoterminal propeptide of type I procollagen were reported for different menopausal stages.
• The method could not discriminate between postmenopausal women and those with osteopenia.

Conclusions:

• The proposed marker plot offers an intuitive visualization of bone turnover.
• It facilitates the perception of the balance between bone formation and resorption.
• This graphical approach aids in understanding individual patient and group bone turnover dynamics.