Camacho Pauline M, Lopez Norma A
Division of Endocrinology and Metabolism, Loyola University Stritch School of Medicine, Maywood, IL 60153, USA.
Clin Chem Lab Med. 2008;46(10):1345-57. doi: 10.1515/CCLM.2008.310.
We currently have guidelines that allow us to use bone densitometry in the diagnosis and management of osteoporosis. The role of biochemical markers of bone turnover (BTMs) is less well defined. Serum and urine BTM patterns in treated and untreated osteoporotic patients have been studied to help us define their role. The aim of this review is to present data which helps elucidate the current role and limitation of BTMs in the management of osteoporosis.
A search of the literature on BTMs was performed. References with keywords, such as bone turnover markers, biochemical markers, monitoring therapy and monitoring osteoporosis, were used.
Literature describing the nature and limitation of currently available BTMs was reviewed. The clinical use and limitation of BTMs in assessing fracture risk reduction, bone mineral density (BMD) and response to therapy is available, whereas definitive guidelines have not yet been created.
BTMs offer a potential non-invasive and reliable way of assessing skeletal activity, studying drug effects and response to therapies, assessing fracture risk and predicting other skeletal parameters, such as bone loss, BMD and bone mass. A 30%-70% reduction in bone resorption markers can be achieved with antiresorptive therapy, and 30%-50% increase in bone formation markers with anabolic therapy. We recommend that clinicians understand and incorporate the measurement of BTMs in the management of osteoporosis.
我们目前有指南允许在骨质疏松症的诊断和管理中使用骨密度测定法。骨转换生化标志物（BTMs）的作用尚不明确。已对接受治疗和未接受治疗的骨质疏松症患者的血清和尿液BTM模式进行了研究，以帮助我们明确其作用。本综述的目的是呈现有助于阐明BTMs在骨质疏松症管理中当前作用和局限性的数据。
对有关BTMs的文献进行了检索。使用了带有“骨转换标志物”“生化标志物”“监测治疗”和“监测骨质疏松症”等关键词的参考文献。
对描述当前可用BTMs的性质和局限性的文献进行了综述。有关于BTMs在评估骨折风险降低、骨矿物质密度（BMD）和治疗反应方面的临床应用及局限性的资料，然而尚未制定明确的指南。
BTMs提供了一种潜在的非侵入性且可靠的方法，可用于评估骨骼活性、研究药物效果和治疗反应、评估骨折风险以及预测其他骨骼参数，如骨质流失、BMD和骨量。抗吸收治疗可使骨吸收标志物降低30% - 70%，合成代谢治疗可使骨形成标志物增加30% - 50%。我们建议临床医生在骨质疏松症的管理中理解并纳入BTMs的测量。
