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Bone turnover: Biology and assessment tools.

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  • 1INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Place d'Arsonval, 69437, Lyon, France.

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|November 20, 2018
PubMed
Summary

Bone turnover markers (BTM) like PINP and CTX-I help monitor osteoporosis treatment response. While BTMs don't predict fractures, they assess therapy effectiveness and patient compliance.

Keywords:
C-terminal telopeptide of type I collagenN-terminal extension propeptide of type I procollagenanti-osteoporosis treatmentbone turnover markersosteoporosis

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Area of Science:

  • Biochemistry
  • Endocrinology
  • Orthopedics

Background:

  • Bone turnover involves resorption and formation.
  • N-terminal propeptide of type I procollagen (PINP) and C-telopeptide of type I collagen (CTX-I) are recommended markers for bone formation and resorption.
  • Bone turnover markers (BTM) are influenced by factors like feeding and fractures, necessitating controlled pre-analytical conditions.

Purpose of the Study:

  • To review the clinical utility of bone turnover markers (BTMs) in managing osteoporosis.
  • To discuss the interpretation and application of BTMs in assessing treatment response and compliance.
  • To define target levels for BTMs during anti-osteoporosis therapy.

Main Methods:

  • Literature review on bone turnover markers (PINP and CTX-I).
  • Analysis of factors affecting BTM variability.
  • Evaluation of BTMs' role in monitoring anti-osteoporosis treatments.

Main Results:

  • BTMs are recommended by international organizations for clinical use.
  • BTMs do not predict bone loss or fracture risk in individuals.
  • BTMs reflect metabolic changes during osteoporosis treatment; anti-resorptive drugs decrease resorption markers, while bone-formation stimulating drugs increase formation markers.

Conclusions:

  • BTMs are valuable for monitoring anti-osteoporosis therapy response and compliance.
  • Specific target levels for PINP exist for anti-resorptive and bone-formation stimulating therapies.
  • Controlling pre-analytical variability is crucial for accurate BTM interpretation.