Biochemical markers of bone turnover

In a study with 40 healthy men and women, average age 63.7 years, who were randomized to either an alkali diet (meat plus fruits and vegetables) or an acid diet (meat plus cereal grains) (Jajoo and others 2006), altering the renal net acid excretion over a period of 60 days affected several biochemical markers of bone turnover and calcium excretion. The acidity of the diet had a significant effect on increasing NTX, a urinary marker of bone breakdown, and increasing the amount of calcium excreted in the urine. 

Miller, P.D., et al., "Practical Clinical Application of Biochemical Markers of Bone Turnover," /. Clin. Densitometry 2, 323-342 (1999). 

Kanbur, N. O., Derman, O., and Kinik, E. (2002). Osteocalcin. A biochemical marker of bone turnover during puberty. Int.. Adolesc. Med. Health 14,235-244. 

Glucocorticoids can even cause osteoporosis when they are used for long-term replacement therapy in the Addison s disease, as has been shown by a study of 91 patients who had taken glucocorticoids for a mean of 10.6 years, in whom bone mineral density was reduced by 32% compared with age-matched controls (SEDA-19, 377 198). However, these results contrasted with the results of a Spanish study in patients with Addison s disease, in which no direct relation was found between replacement therapy and either bone density or biochemical markers of bone turnover of calcium metabolism (alkaline phosphatase, osteocalcin, procollagen I type, parathormone, and 1,25-dihydroxycolecalciferol) (SEDA-19, 377 199). 

Although studies in which biochemical markers of bone turnover are measured for periods of 1-2 months do not predict the development of bone thinning, osteoporosis, or fracture, they can be useful in comparing the potential effects on bone of different glucocorticoids. Studies of bone mineral density over longer time periods relate more directly to osteoporosis and fracture risk. 

B3. Beck-Jensen, J. E., Kollerup, G., Soerensen, H. A., Pors Nielsen, S., and Soerensen, O. H., A single measurement of biochemical markers of bone turnover has limited utility in the individual persons. Scand. J. Clin. Lab. Invest. 57, 351-360 (1997). 

B4. Blumsohn, A., and Eastell, R., The performance and utility of biochemical markers of bone turnover Do we know enough to use them in clinical practice Ann. Clin. Biochem. 34,449 159 (1997). 

Metabolic bone disease in children receiving parenteral nutrition manifests primarily as osteopenia and, on occasion, fractures (5). The etiology is multifactorial calcium and phosphate deficiency play a major role in the preterm infant but the part played by aluminium toxicity in this population is unknown. Lack of reference values of bone histomorphometry in the premature infant, as well as lack of reference data for biochemical markers of bone turnover in these patients, contributes to the uncertainty. Other factors that may play a role in the pathogenesis of bone disease associated with parenteral nutrition include lack of periodic enteral feeding underljdng intestinal disease, including malabsorption and inflammation the presence of neoplasms and drug-induced alterations in calcium and bone metabohsm. However, the true incidence and prevalence of parenteral nutrition-associated bone abnormalities in pediatric patients are unknown. 

Hannon R, EasteU R. Preanalytical variability of biochemical markers of bone turnover. Osteoporos Int 2000 ll S30-44. 

Alvarez L, Guanabens N, Peris P. Discriminative value of biochemical markers of bone turnover in assessing Paget s disease. J Bone Miner Res 1995 10 458-65. 

Christiansen C, Hassager C, Riis BJ. Biochemical markers of bone turnover. In Avioli LV, Krane SM, eds. Metabohc bone disease, 3rd ed. San Diego Academic Press, 1998 313-26. 

Delmas PD. Biochemical markers of bone turnover for the clinical assessment of metabolic bone disease. Endocrinol Metab Clin North Am 1990 19 1-18. 

Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J. The use of biochemical markers of bone turnover in osteoporosis. Osteoporosis Int 2000 Suppl 6 52-17. 

Gallacher SJ, Fraser WD, Owens OJ, Dryburgh FJ, Logue FC, Jenkins A, et al. Changes in calciotrophic hormones and biochemical markers of bone turnover in normal pregnancy. Eur J Endocrinol 1994 131 369-74. 

Garnero P, Shih W], Gineyts E, Karpf DB, Delmas PD. Comparison of new biochemical markers of bone turnover in late postmenopausal osteoporotic women in response to alendronate treatment. J Clin Endocrmol Metab 1994 79 1693-700. 

Khosla S, Kleerekoper M. Biochemical markers of bone turnover. In Favus MJ, ed. Primer on the meta-bohc bone diseases and disorders of mineral metabolism, 4th ed. Philadelphia Lippincott, Williams 8c Wilkins, 1999 128-33. 

Miller PD, Baran DT, Bilezhdan JP, Greenspan SL, Lindsay R, Riggs BL, et al Practical clinical application of biochemical markers of bone turnover consensus of an expert panel. J Clin Densitom 1999 2 323-42. 

Woitge HW, Seibel MJ. Risk assessment for osteoporosis II biochemical markers of bone turnover bone resorption indices. CUn Lab Med 2000 503-25. 

PD Delmas. Biochemical markers of bone turnover. 1. theoretical considerations and clinical use in osteoporosis. Am J Med 95 5A—16S, 1993,... 

M. Sowers, D. Eyre, B. W. Hollis, et ah Biochemical markers of bone turnover in lactating and nonlactating po.stpartum women. Journal of Clinical Endocrinology and Metabolism 80,2210 (1995). 

Rix M, et al. Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney Int 1999 56 1084-1093. 

Komi, J., Lankinen, K.S., DeGregorio, M., Heikkinen, J., Saarikoski, S., Tuppurainen, M., Halonen, K., Lammintausta, R., Vaananen, K., Ylikorkala, O. and Erkkola, R. (2006) Effects of ospemifene and raloxifene on biochemical markers of bone turnover in postmenopausal women. Journal of Bone and Mineral Metabolism, 24, 314—318. 

Plebani, M., D. Bernard , M. E. Meneghetti, R Ujka, and M. Zaninotto. 2000. Biological variability in assessing biochemical markers of bone turnover. Clinica Chimica Acta 299 77-86. 

Tordjman, C., A. Lhumeau, P. Pastoureau, R Meunier, B. Serkiz, J. P. Volland, and J. Bonnet. 1994. Evaluation and comparison of urinary pyridinium cross-hnks in two rat models of bone loss—Ovariectomy and adjuvant polyarthritis. Bone and Mineral 26 155-167. Vanderschueren, D., I. Jans, E. van Herck, K. Moermans, J. Verhaeghe, and R. Bouillon. 1994. Time-related increase of biochemical markers of bone turnover in androgen-deficient male rats. Bone and Mineral 26 123-131. 

Paget s disease (Table 35.6) is characterized by excessive bone resorption, followed by replacement of the normally mineralized bone with soft, poorly mineralized tissue (20). It has been determined that the osteoclasts have an abnormal structure, are hyperactive, and are present at elevated levels (20). Patients afflicted with this painful condition often suffer from multiple compression fractures. Administration of calcitonin and oral calcium and phosphate supplements had been the treatment of choice until the bisphosphonate risedronate was approved by the U.S. Food and Drug Administration (FDA). Daily administration of risedronate results in a decreased rate of bone turnover and a decrease in the levels of serum alkaline phosphatase and urinary hydroxyproline, two biochemical markers of bone turnover (4,20). A significant advantage to treatment with the bisphosphonates is long-term suppression of the disease (20). Calcium supplementation, which often is necessary in these patients, must be dosed separately from risedronate, because calcium- and aluminum- or... 

Weaver, C.M., Peacock, M., Martin, B.R., McCabe, G.P., Zhao,)., Smith, D.L, and Wastney, M.E. (1997) Quantification of biochemical markers of bone turnover by kinetic measures of bone formation and resorption in young healthy females. J. Bone Miner. Res., 12, 1714-1720. 

Nettekoven S, Strohle A, Trunz B, Wolters M, Hoffmann S, Horn R, Steinert M, Brabant G, Lichtinghagen R, Welkoborsky HJ, Tuxhorn I, Hahn A. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy. Eur J Pediatr 2008 167(12) 1369-77. 

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