201 - Biochemical markers of bone turnover in postmenopausal osteoporosis

Abstract

Bone turnover comprises two processes: the removal of old bone (resorption) and the laying down of new bone (formation). N-terminal propeptide of type I procollagen (PINP) and C-telopeptide of type I collagen (CTX-I), markers of bone formation and resorption, respectively, are recommended for clinical use. Bone turnover markers (BTMs) can be measured on several occasions in one individual with good precision. However, they are subject to several sources of variability, including feeding (resorption decreases) and recent fracture (all markers increase for several months). BTMs are not used for diagnosis of osteoporosis and do not improve prediction of bone loss or fracture within an individual. In untreated women, very high BTM concentrations suggest secondary causes of high bone turnover (e.g., bone metastases or multiple myeloma). In people with osteoporosis, BTMs might be useful to assess the response to anabolic and antiresorptive therapies, to assess compliance to therapy, or to indicate possible secondary osteoporosis. Much remains to be learned about how BTMs can be used to monitor the effect of stopping bisphosphonate therapy (e.g., to identify a threshold above which restarting therapy should be considered). More studies are needed to investigate the use of BTMs for assessment of the bone safety of new medications.