Abstract

REYNAGA MONTECINOS, Belen  and  ZENI, Susana Noemí. Biochemical markers of bone remodelling: Clinical utility. Acta bioquím. clín. latinoam. [online]. 2009, vol.43, n.2, pp.177-193. ISSN 0325-2957.

Bones are continuously undergoing remodeling as a result of the coordinated actions of bone cells. This process occurs in discrete regions or basic multicellular units (BMUs) and ensures the maintenance of skeletal integrity and bone mass. The rate of bone remodelling can be monitored quantitatively by measuring biochemical markers of bone turnover. Bone formation markers (bone alkaline phosphatase, osteocalcin, type I collagen extension propeptides) reflect osteoblast activity and bone resorption markers (pyridinium crosslinks, N-terminal type I collagen C-crosslinking telopeptides, tartrate resistant acid phosphatase 5-b, hydroxyproline and urinary calcium) reflect osteoclast activity. Bone markers are useful to detect changes in bone turnover. As bone resorption is faster than bone formation, the increase in bone turnover markers can be regarded as a risk factor for rapid bone loss. Although bone markers provide little information in osteoporosis diagnosis, they can identify fast bone losers who will benefit from a preventive therapy and thereafter monitor the efficacy of the treatment. The most sensitive and specific markers may predict fractures risk, independently of bone density. For interpreting the results of the bone marker test used, it is necessary to consider the main sources of variability which include preanalytical, analytical and biological conditions.

Keywords : Biochemical bone markers; Bone remodelling; Osteoporosis; Bone formation and resorption markers; Clinical utility.

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