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Biochemical markers of bone turnover

S B Rosalki1

  • 1Unilabs Clincial Pathology, London, UK.

International Journal of Clinical Practice
|September 23, 1998
PubMed
Summary

Measuring multiple bone markers is recommended for accurate diagnosis of bone disorders. Simple enzyme tests like bone-specific alkaline phosphatase are often sufficient initial investigations for conditions such as osteomalacia.

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Area of Science:

  • Biochemistry
  • Endocrinology
  • Orthopedics

Background:

  • Bone markers reflect diverse aspects of bone health and cellular function.
  • Osteolytic and osteoblastic activities can be altered independently or concurrently.
  • Individual bone markers may not exhibit parallel changes, necessitating multi-marker assessment.

Purpose of the Study:

  • To evaluate the utility of various bone markers in diagnosing bone disorders.
  • To determine the optimal combination of markers for specific conditions.
  • To establish a guideline for the sequential use of bone marker assays.

Main Methods:

  • Review of existing literature on bone marker assays.
  • Analysis of marker profiles in different bone diseases.
  • Comparison of enzyme-based assays with complex immunoassays.

Main Results:

  • Bone-specific alkaline phosphatase (BSALP) is adequate alone for osteomalacia, Paget's disease, and hyperparathyroidism.
  • BSALP combined with tartrate-resistant acid phosphatase (TRAP) is recommended for metastatic disease and multiple myeloma.
  • Osteoporosis investigation benefits from BSALP and TRAP, with added value from urine deoxypyridinoline and serum collagen telopeptide.

Conclusions:

  • Multi-marker strategies are crucial for comprehensive bone disorder diagnosis.
  • Simple enzyme measurements serve as effective initial diagnostic tools.
  • Tailored marker combinations improve diagnostic accuracy for specific skeletal pathologies.

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