Markers for bone remodeling
What markers are available to assess bone remodeling and how are they used?
| Bone formation | Bone resorption |
|---|---|
| Serum alkaline phosphatase | Urine or serum N-telopeptides (NTX) |
| Serum Osteocalcin | Serum C-telopeptides (CTX) |
| Serum P1NP |
Elevation of biomarkers predicts future bone loss. A 30% reduction of biomarkers after therapy is initiated verifies compliance and predicts an increase in bone mass. However, marked variability in biomarker measurement limits the utility of this tool. A serum CTX <312 ng/L and/or urine NTX <27nmol/mmolCr indicates good control.
