Markers for bone remodeling

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Markers for bone remodeling

What markers are available to assess bone remodeling and how are they used?

Bone formationBone resorption
Serum alkaline phosphataseUrine or serum N-telopeptides (NTX)
Serum OsteocalcinSerum 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.

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