Markers of bone turnover

Harrison et al., 1998 10 week old OVX rats low calcium diet treatment starts 2 weeks after OVX Soy protein with isoflavones (6 mg/d) for 4 weeks Reduced bone loss (higher bone weight, higher calcium content) but no decrease of markers of bone turnover for the soy group... 

WANGEN K E, DUNCAN A M, MERZ-DEMLOW B E, XU X, MARCUS R, PHIPPS W R, KURZER M S (2000) Effects of soy isoflavones on markers of bone turnover in premenopausal and postmenopausal women. J Clin Endocrin Metab 85(9), 3043-8. 

Antioxidants in fruits and vegetables including vitamin C and (3-carotene reduce oxidative stress on bone mineral density, in addition to the potential role of some nutrients such as vitamin C and vitamin K that can promote bone cell and structural formation (Lanham-New 2006). Many fruits and vegetables are rich in potassium citrate and generate basic metabolites to help buffer acids and thereby may offset the need for bone dissolution and potentially preserve bone. Potassium intake was significantly and linearly associated with markers of bone turnover and femoral bone mineral density (Macdonald and others 2005). 

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. 

Lin P-H, Ginty F, Appel L, Aickin M, Bohannon A, Gamero P, Barcaly D and Svetkey L. 2003. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. 

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. 

Consumption of soy foods (providing 60mg/day isoflavones) for 12 weeks by postmenopausal women has been found to significantly decrease clinical risk factors for osteoporosis (short-term markers of bone turnover) including decreased urinary M-telopeptide excretion (bone resorption marker) and increased serum osteocalcin (bone formation marker). Furthermore, consumption of a soy isoflavone supplement containing 61.8 mg of isoflavones for 4 weeks by postmenopausal Japanese women significantly decreased excretion of bone resorption markers. ... 

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. 

In 47 children treated with depot leuprolide acetate for precocious puberty for 2 years, bone mineral density decreased significantly and markers of bone turnover increased significantly during treatment but were normal for age 2 years after treatment was withdrawn (54). 

Parkinson, C., Kassem, M., Heickendorff, L., et al. PEGvisomant-induced serum insulin-like growth factor-I normalization in patients with acromegaly returns elevated markers of bone turnover to normal. J. Clin. Endocrinol. Metab. 88(12) 5650-5655. 2003. 

Variability of the Results of Measurements of the Markers of Bone Turnover. 284... 

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. 

Laboratory and other findings include increased markers of bone turnover, and abnormal radiographs and bone scans. The most common finding leading to the diagnosis of Paget s disease is increased serum ALP (up to tenfold). Increases in markers of bone resorption (N-telopeptide, deoxypyridinohne, and C-telopeptide) reflect the osteoclas-... 

In addition to their use m metabohc bone disease, markers of bone turnover are potentially useful tools in diagnosing and monitoring metastatic bone disease. As with metabolic bone disease, there is more evidence supporting the use of resorption markers m monitoring therapy. Additional studies are required to determine the ultimate clinical utility of bone markers in metastatic bone disease. 

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. 

Calvo MS, Eyre DR, Gundberg CM. Molecular basis and clinical application of biological markers of bone turnover. Endocr. Rev, 1996 17 333-68. 

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. Markers of bone turnover for monitoring osteoporosis with antiresorptive drugs. Osteoporosis Int 2000 S6 S66-76. 

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. 

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