32(02) 105-112 
| Current Recommendations for Laboratory Testing and Use of Bone Turnover Markers in Management of Osteoporosis |
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| Jehoon Lee, M.D.1, and Samuel Vasikaran, M.D.2 | | Department of Laboratory Medicine1, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Core Clinical Pathology and
Biochemistry2, PathWest-Royal Perth Hospital, WA, Australia | |
| Osteoporosis is a major health problem worldwide, and is projected to increase exponentially
due to the aging of the population. The absolute fracture risk in individual subjects is
calculated by the use of algorithms which include bone mineral density (BMD), age, gender,
history of prior fracture and other risk factors. This review describes the laboratory investigations
into osteoporosis which include serum calcium, phosphate, creatinine, alkaline
phosphatase and 25-hydroxyvitamin D and, additionally in men, testosterone. Parathyroid
hormone (PTH) is measured in patients with abnormal serum calcium to determine
its cause. Other laboratory investigations such as thyroid function testing, screening
for multiple myeloma, and screening for Cushing’s syndrome, are performed if indicated.
Measurement of bone turnover markers (BTMs) is currently not included in algorithms for
fracture risk calculations due to the lack of data. However, BTMs may be useful for monitoring
osteoporosis treatment. Further studies of the reference BTMs serum carboxy terminal
telopeptide of collagen type I (s-CTX) and serum procollagen type I N-terminal propeptide
(s-PINP) in fracture risk prediction and in monitoring various treatments for osteoporosis
may help expedite their inclusion in routine clinical practice. |
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2012 Mar; 32(02) 105-112 |
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| DOI : http://dx.doi.org/10.3343/alm.2012.32.2.105 |
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| Keyword : Osteoporosis, Bisphosphonates, Bone turnover markers, Fracture risk, Monitoring treatment |
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