Diagnostic Value of Biochemical Markers of Bone Turnover and Postmenopausal Osteoporosis

Abstract We studied 77 women divided into postmenopausal osteoporotic and premenopausal and postmenopausal non-osteoporotic groups in order to evaluate bone metabolism and diagnostic value of biochemical markers of bone turnover in postmenopausal osteoporosis. Postmenopausal osteoporotic (n: 40), postmenopausal non-osteoporotic (n: 24) and premenopausal nonosteoporotic (n: 13) groups were defined according to bone mineral density (BMD) scores obtained with dual energy X-ray absorptiometry (DEXA). Urinary deoxypyridinoline (Dpd), pyridinoline (Pyd), serum total alkaline phosphatase (ALP), bone specific alkaline phosphatase (BALP), osteocalcin (BGP), total calcium, phosphorus, and creatinine levels were determined. Urinary Dpd and Pyd levels of postmenopausal osteoporotic group (8.7 and 18.7 μmol/mg creatinine) were significantly higher than postmenopausal control (5.1 and 11.7 μmol/mg creatinine, p<0.0001) and premenopausal control (6.0 and 13.0 μmol/mg creatinine, p<0.0005 and p<0.001) groups. Bone formation markers were not significantly different between groups, although BGP correlated with Dpd and Pyd (r: 0.26 and r: 0.31, p<0.05) in osteoporotic subjects. From receiver operating curve (ROC) analysis Dpd had the best diagnostic value (0.846), followed by Pyd (0.802) in evaluation of osteoporosis, whereas BALP (0.570) and BGP (0.528) were relatively inefficient in the discrimination of postmenopausal osteoporosis. This study suggests that bone resorption markers are more efficient than bone formation markers in the diagnosis of postmenopausal osteoporosis. Urinary Dpd/creatinine ratio has the highest diagnostic value.

[1]  J. Bruder,et al.  Evaluation and treatment of postmenopausal osteoporosis. , 2001, The American journal of managed care.

[2]  M. Seibel,et al.  Improved purification of human bone sialoprotein and development of a homologous radioimmunoassay. , 1997, Clinical chemistry.

[3]  S. Leigh,et al.  Comparison of analytical performance and biological variability of three bone resorption assays. , 1997, Clinical chemistry.

[4]  S. Pors Nielsen,et al.  A single measurement of biochemical markers of bone turnover has limited utility in the individual person. , 1997, Scandinavian journal of clinical and laboratory investigation.

[5]  R. Eastell,et al.  Biochemical Markers of Bone Resorption Compared with Estimates of Bone Resorption from Radiotracer Kinetic Studies in Osteoporosis , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[6]  Lambertus W. J. J. M. Westerhuis,et al.  Diagnostic Value of Some Biochemical Bone Markers for the Detection of Bone Metastases in Prostate Cancer , 1997, European journal of clinical chemistry and clinical biochemistry : journal of the Forum of European Clinical Chemistry Societies.

[7]  M. Plebani,et al.  New and traditional serum markers of bone metabolism in the detection of skeletal metastases. , 1996, Clinical biochemistry.

[8]  C. Murray,et al.  Osteoporosis workup: evaluating bone loss and risk of fractures. , 1995, Geriatrics.

[9]  O. Nakade,et al.  Phenytoin increases markers of osteogenesis for the human species in vitro and in vivo. , 1995, The Journal of clinical endocrinology and metabolism.

[10]  R. Eastell,et al.  Apparent instability of osteocalcin in serum as measured with different commercially available immunoassays. , 1995, Clinical chemistry.

[11]  R. Ferrara,et al.  Urinary and synovial pyridinium crosslink concentrations in patients with rheumatoid arthritis and osteoarthritis. , 1995, Annals of the rheumatic diseases.

[12]  C. Libanati,et al.  Biochemical markers of bone turnover for the clinical assessment of bone metabolism. , 1994, Rheumatic diseases clinics of North America.

[13]  P. Delmas,et al.  Characterization of immunoreactive forms of human osteocalcin generated in vivo and in vitro , 1994, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[14]  J. Eisman,et al.  Prediction of bone density from vitamin D receptor alleles , 1994, Nature.

[15]  P. Delmas,et al.  Biochemical markers of bone turnover , 1993, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[16]  P. Delmas,et al.  Assessment of the serum levels of bone alkaline phosphatase with a new immunoradiometric assay in patients with metabolic bone disease. , 1993, The Journal of clinical endocrinology and metabolism.

[17]  T. Ohishi,et al.  Age-related changes of urinary pyridinoline and deoxypyridinoline in Japanese subjects. , 1993, Clinical and investigative medicine. Medecine clinique et experimentale.

[18]  A. Ratcliffe,et al.  Urinary hydroxypyridinium crosslinks of collagen as markers of bone resorption and estrogen efficacy in postmenopausal osteoporosis , 1993, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[19]  Truls Østbye,et al.  An evaluation of several biochemical markers for bone formation and resorption in a protocol utilizing cyclical parathyroid hormone and calcitonin therapy for osteoporosis. , 1993, The Journal of clinical investigation.

[20]  A. Lane,et al.  Treatment of Postmenopausal Osteoporosis with Transdermal Estrogen , 1992, Annals of Internal Medicine.

[21]  K. Miura,et al.  Serum concentrations of osteocalcin in patients with hyperthyroidism, hypothyroidism and subacute thyroiditis , 1992, Journal of endocrinological investigation.

[22]  R. Wolfert,et al.  Bone Alkaline Phosphatase in Paget's Disease , 1991, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[23]  P. Pacini,et al.  Osteocalcin as a biological marker in the therapeutic management of breast cancer bone metastases. , 1989, Cancer investigation.

[24]  J. Pødenphant,et al.  Bone turnover in spinal osteoporosis , 1987, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[25]  W. Zontine Bone disease. , 1976, Modern veterinary practice.