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Expert Lists Pros and Cons Of Bone Turnover Markers


 

SAN DIEGO — A chief advantage of assessing bone turnover markers such as serum osteocalcin and urine hydroxyproline in osteoporosis patients is that they provide an integrated assessment of skeletal metabolism, Dr. Marc C. Hochberg reported at the annual meeting of the International Society for Clinical Densitometry.

Among other advantages of using these markers:

▸ They show rapid and large changes with therapy.

▸ Automated assays are widely available, and they are less expensive than dual-energy x-ray absorptiometry, although more expensive than ultrasound.

▸ Elevated bone turnover is associated with fracture risk, independent of bone mineral density.

However, “as with everything, there are advantages and limitations” to bone turnover markers, said Dr. Hochberg, head of the division of rheumatology and clinical immunology at the University of Maryland, Baltimore.

For example, some bone markers reflect both bone formation and bone resorption.

Also, “most of the markers are present in tissues other than bone and may be influenced by nonskeletal processes,” he said.

Further, changes in bone turnover markers are not disease specific, and measurement of the markers varies.

Potential uses for bone turnover markers include the ability to predict the rate of future bone loss and the occurrence of osteoporotic fractures, to monitor the efficacy of treatment, to enhance adherence to therapy, to identify patients for treatment, and to allow selection of the optimal agent.

Most 'are present in tissues other than bone and may be influenced by nonskeletal processes.' DR. HOCHBERG

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