Cited by 596Bone health and osteoporosis researchBone health and treatmentsBone Metabolism and Diseases

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Use of bone turnover markers in postmenopausal osteoporosis

Eastell, Richard, Szulc, Pawel·2017·The Lancet Diabetes & Endocrinology

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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) are markers of bone formation and resorption, respectively, that are recommended for clinical use. Bone turnover markers can be measured on several occasions in one individual with good precision. However, these markers are subject to several sources of variability, including feeding (resorption decreases) and recent fracture (all markers increase for several months). Bone turnover markers 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 bone turnover marker concentrations suggest secondary causes of high bone turnover (eg, bone metastases or multiple myeloma). In people with osteoporosis, bone turnover markers 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 learnt about how bone turnover markers can be used to monitor the effect of stopping bisphosphonate therapy (eg, to identify a threshold above which restarting therapy should be considered). More studies are needed to investigate the use of bone turnover markers for assessment of the bone safety of new medications.

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Authors: Eastell, R., & Szulc, P.
Affiliations: University of Sheffield (GB)
Corresponding author: Eastell, Richard
ORCID: Eastell, Richard
Venue: The Lancet Diabetes & Endocrinology
Publisher: Elsevier BV
Published: 2017-11
Volume: 5
Issue: 11
Pages: 908-923
ISSN: 2213-8587 (ISSN-L)
DOI: 10.1016/s2213-8587(17)30184-5
OpenAlex: W2733907025
Cited by: 594
References: 168
Citations by year: 2026: 62 · 2025: 94 · 2024: 89 · 2023: 82 · 2022: 92 · 2021: 75 · 2020: 47 · 2019: 32 · 2018: 18 · 2017: 3
FWCI: 4.97
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet Diabetes & Endocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute for Health and Care Research (NF-SI-0513-10073)
Medical Research Council (MR/K006312/1, MR/P020941/1)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Oncology › Bone health and treatments
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Keywords: bone turnover markers, postmenopausal osteoporosis, bone resorption, bone formation, P1NP, C-terminal telopeptide of type I collagen, secondary osteoporosis, fracture risk prediction
MeSH terms: Diphosphonates, Humans, Biomarkers, Bone Density, Osteoporosis, Postmenopausal, Bone Remodeling, Fracture Healing, Bone Density Conservation Agents

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Use of bone turnover markers in postmenopausal osteoporosis

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