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Noninvasive parameters of bone metabolism
H Schmidt-Gayk1, H J Roth, S Becker
1Endocrine Laboratory, Laboratory Group, Heidelberg, Germany.
Current Opinion in Nephrology and Hypertension
|July 1, 1995
Summary
Bone-specific alkaline phosphatase is a stable marker for osteoblastic activity, outperforming osteocalcin. Urinary pyridinoline and deoxypyridinoline are key for measuring bone resorption, with newer assays emerging.
Area of Science:
- Biochemistry
- Orthopedics
- Clinical Chemistry
Background:
- Accurate assessment of bone turnover is crucial for diagnosing and managing bone diseases.
- Existing serum markers for bone formation and resorption have limitations in specificity, stability, and dependence on renal function.
Purpose of the Study:
- To review and compare current serum and urinary markers for bone formation and resorption.
- To highlight advances in immunoassay techniques for bone marker quantification.
Main Methods:
- Review of literature on established and emerging bone turnover markers.
- Comparison of marker stability, specificity, and assay methodologies.
- Discussion of immunoassay advancements for bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase.
Main Results:
- Bone-specific alkaline phosphatase is a superior marker for osteoblastic activity due to its stability and hepatic degradation.
- Osteocalcin (bone gamma-carboxyglutamic acid peptide) lacks specificity and stability, with elimination dependent on glomerular filtration rate.
- Urinary pyridinoline and deoxypyridinoline are current gold standards for bone resorption, with potential replacement by type I collagen crosslinked N-telopeptide (CrossLaps).
Conclusions:
- Bone-specific alkaline phosphatase offers a reliable measure of bone formation.
- Newer assays for bone resorption markers like CrossLaps and tartrate-resistant acid phosphatase show promise for improved clinical utility.