Markers Of Bone Turnover In Diagnosis Research Articles

The role of bone turnover markers in diagnosis, monitoring, and pathological fractures of osteoporosis.

We investigated the utility of specific biomarkers-namely, c-terminal telopeptide (CTX), n-telopeptide (NTX), deoxypyridinoline (DPD), and tartrate-resistant acid phosphatase (TRAP)-compared to conventional diagnostic methods. We hy-pothesized that these novel biomarkers could hold substantial value in the diagnosis, treatment, and monitoring of osteoporosis. The study was conducted over a three-year period, from January 1, 2020, to January 1, 2023. We enrolled a total of 520 patients aged 50 years or older who had been diagnosed with osteoporosis. Patients undergoing steroid treatments, which are known to contribute to osteoporosis, were excluded from the study. Additionally, we carefully selected and matched a control group consisting of 500 patients based on demographic characteristics relevant to the diagnosis of osteoporosis. This meticulous selection process resulted in a comprehensive cohort comprising 1,020 patients. Throughout the study, patients were closely monitored for a duration of one year to track the occurrence of pathological fractures and assess their overall prognosis. As a result of our rigorous investigation, we identified CTX, NTX, DPD, and TRAP as pivotal biomarkers that play a crucial role in evaluating bone health, monitoring treatment effectiveness, and detecting pathological fractures in the context of osteoporosis. Our study underscores the significance of these biomarkers in advancing the diagnosis and management of osteo-porosis, offering valuable insights into the disease's progression and treatment outcomes.

Long term effects on biochemical bone markers of a single infusion of zoledronic acid in Paget disease of bone

BackgroundThe aim of the present study is to evaluate long term biochemical response to a single dose of zoledronic acid in patients with Paget disease of bone, as well as evaluating the value of bone turnover markers in diagnosis and follow-up. MethodsThis is an observational, descriptive and prospective study. Included patients received a single-dose intravenous infusion of 5 mg zoledronic acid. Bone turnover markers were measured at baseline, and in every follow up visit. ResultsThirty-nine patients with a mean follow-up of 56.49 months were included. At the time Paget disease was diagnosed, all of the patients (100%) had high serum procollagen type 1 amino-terminal propeptide values, but not all patients had high serum C-terminal telopeptide and alkaline phosphatase values (85% and 89% respectively). Biochemical response to therapy occurred in 38 out of 39 patients (97%). Two patients had partial response at 6 months but complete response thereafter. Only one patient relapsed (nadir procollagen type 1 amino-terminal propeptide 35.06 μg/l, value at relapse 75.2 μg/l) 4.5 years after treatment. Values of serum C-terminal telopeptide and alkaline phosphatase of this patient were normal despite P1NP relapse. ConclusionsWe hence conclude that zoledronic acid is effective in inducing and maintaining biochemical remission and that procollagen type 1 amino-terminal propeptide is a better diagnostic and prognostic marker in PDB when compared to C-terminal telopeptide and alkaline phosphatase.

Sclerostin, periostin and microRNA as potential markers of osteoporosis

In recent years, people have had high hopes for the possibility of using measurements of the so-called modern bone turnover markers in diagnosis, diagnostics of the course and the prediction of the occurrence of complications of bone metabolic diseases, especially osteoporosis. So far, several diagnostic markers of bone turnover have been identified, particular importance attached to PINP and CTx. However, many studies have highlighted that their use in the diagnosis of osteoporosis is rather limited due to their inter-individual and intra-individual variability, tissue non-specificity, the inability to evaluate individual bone tissue compartments, and the ability to assess metabolic activity of only osteoblasts and/or osteoclasts without osteocytes. The data presented in the thesis indicates the potential usefulness of sclerostin measurements, primarily associated with metabolic activity of osteocytes, periostin, as the indicator of metabolic activity of periosteum and microRNAs as the group of specific markers in the early detection of osteoporosis. All of the above-mentioned candidates could possibly become a predictor of osteoporotic fractures: sclerostin in patients with type 2 diabetes; periostin, especially in non-vertebral fractures in postmenopausal women and microRNA in early prediction of these fractures. However, many of the studies underline some of the limitations associated with their use in the diagnosis of osteoporosis. Ambiguous results of the presented studies may be primarily due to population selection, population size, type of fractures and duration of the observation itself. An objective judgement will be made when an adequate number of standardized and independent studies will allow for the exclusion or validation of each of them in clinical practice.