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Biochemical studies in the evaluation and management of osteoporosis: current status and future prospects

Kleerekoper, M.; Edelson, G.W.

Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2(1): 13-19

1996


ISSN/ISBN: 1530-891X
PMID: 15251558
DOI: 10.4158/ep.2.1.13
Accession: 048380333

To examine the current status of biochemical markers of bone remodeling and to offer a perspective on their future clinical applications. We provide a comprehensive overview of the bone remodeling cycle, the hormonal control of bone remodeling, the specific biochemical markers of bone resorption and bone formation, and their current clinical applications. Bone remodeling occurs in discrete packets, known as bone modeling units, on the surfaces of the skeleton. Osteoclasts are responsible for bone resorption, and osteoblasts are responsible for bone formation. Bone resorption and formation are normally coupled, and an imbalance in these processes can lead to metabolic bone diseases such as osteoporosis. Investigators have attempted to measure various biochemical markers of bone resorption (such as urine calcium and hydroxyproline) and formation (such as bone-specific alkaline phosphatase and osteocalcin) as a reflection of response to therapy. Although several markers of bone resorption and formation can be assayed, an ideal marker has yet to be discovered or proved. Until a precise, inexpensive assay is developed, currently available biochemical markers, used in conjunction with measurements of bone density, are considered the most reasonable tools for classifying and directing the management of osteoporosis.

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