Abstract
Bone turnover markers (BTMs) derived from the secretory activities of osteoblasts and the matrix-degrading activities of osteoclasts are useful in monitoring the progression of osteoporosis and the efficacy of anti-osteoporotic treatment. However, the usefulness of BTMs in predicting osteoporosis remains elusive. Osteocytes play a central role in regulating bone formation and resorption. The proteins secreted by osteocytes, such as fibroblast growth factor-23 (FGF23), sclerostin (SOST), and dickkopf-1 (DKK1), could be candidates for osteoporosis screening and fracture prediction. This review summarizes the current evidence on the potential of osteocyte-related proteins as biomarkers for osteoporosis and fracture prediction. The literature reports that SOST may be a potential marker for osteoporosis screening but not for fracture prediction. FGF23 is a potential marker for increased fracture risk, but more studies are needed to confirm its usefulness. The role of DKK1 as a marker to predict osteoporosis and fracture risk cannot be confirmed due to a lack of consistent evidence. In conclusion, circulating osteocyte markers are potential osteoporosis biomarkers, but more studies are warranted to validate their clinical use.
Highlights
IntroductionBone turnover markers (BTMs) are derived from the secretory proteins of osteoblasts (bone formation markers) and the matrix degradation products of osteoclasts (bone resorption markers)
Bone turnover markers (BTMs) are derived from the secretory proteins of osteoblasts and the matrix degradation products of osteoclasts. They provide a snapshot of the bone remodelling process, which is valuable in monitoring the progression of bone-related diseases and the efficacy of osteoporosis treatment [1,2]
Traditional BTMs may not represent individual skeletal health status because multiple studies have reported the absence of a significant association between BTMs and bone mineral density (BMD) [3], even among patients with osteoporosis [4]
Summary
Bone turnover markers (BTMs) are derived from the secretory proteins of osteoblasts (bone formation markers) and the matrix degradation products of osteoclasts (bone resorption markers). They provide a snapshot of the bone remodelling process, which is valuable in monitoring the progression of bone-related diseases and the efficacy of osteoporosis treatment [1,2]. Recent studies have unveiled the role of osteocytes, the most abundant cells in the skeleton, in regulating bone turnover [8]. Osteocytes act as mechanosensors in the bone and regulate the activities of osteoblasts and osteoclasts [10]. Osteocytes secrete osteoprotegerin and receptor activator of nuclear factor kappa-B ligand (RANKL) to regulate
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