Biochemical bone turnover markers in children and adolescents

Abstract

Bone is a dynamic tissue that consistently undergoes remodeling. During formation and resorption processes, bone turnover markers are released. They are specific bone-derived molecules that circulate in the blood or are present in the urine reflecting the bone metabolic activity (during childhood and adolescence: bone growth in length, modeling and remodeling). The use of biochemical bone turnover markers provides dynamic indices of bone turnover and complements the static measures of bone, such as measurement of bone mineral density using DEXA or measurement of bone geometry, mass and density using quantitative computed tomography. The assay of bone markers may be repeated at much shorter intervals than remaining measurements so may help in detecting influence of disease or effects of therapy much earlier than changes in bone mass or progression in bone disease can be ascertained. The usefulness of determination of bone turnover markers in children and adolescents requires that the influence of age, sex and pubertal stage be taken into consideration to interpret the results correctly. Bone turnover markers are used in children and adolescents to assess bone metabolic disorders, monitoring disease progression and antiresorptive therapy.