1Department of Clinical Biochemistry, PathWest Laboratory Medicine, Royal Perth and Fremantle Hospitals, Perth 2School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands 3School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA 4Clinical Biochemistry Unit, Alfred Pathology Service, Melbourne 5Monash University, Melbourne, Vic, Australia.
Pathology. 2014 Jun;46(4):267-73. doi: 10.1097/PAT.0000000000000092.
Bone turnover markers (BTMs) are either secreted by osteoblasts during bone formation or released by degradation of the collagen matrix of bone during bone resorption, and may be measured in blood or urine to provide an estimate of the rate of bone remodelling. Increased bone remodelling rate is often associated with bone loss which can result in osteoporosis; however, lack of data preclude the inclusion of BTMs in fracture risk algorithms. The changes in BTMs following therapy for osteoporosis may be useful for monitoring. Serum procollagen type I amino-terminal propeptide (s-PINP) and serum carboxy-terminal cross-linking telopeptide of type I collagen (s-βCTX) have been designated as reference standard markers of bone formation and resorption respectively in osteoporosis; further research is needed for their routine use in osteoporosis. BTMs are useful in diagnosing and monitoring Paget's disease of bone and other bone diseases associated with abnormal bone formation and/or resorption. Standardised patient preparation is required to mitigate the effect of biological variation, and appropriate sample handling and storage are important to minimise sample degradation. Significant inter-method differences exist for BTMs, and harmonisation of methods for the reference BTMs is being pursued. This will help develop universally accepted decision limits and treatment goals. Australian consensus reference intervals have been developed for some methods for s-PINP and s-βCTX.
骨转换标志物 (BTM) 是在骨形成过程中由成骨细胞分泌的，或者是在骨吸收过程中胶原基质降解时释放的，可在血液或尿液中测量，以估计骨重建的速度。骨重建率的增加通常与骨丢失有关，从而导致骨质疏松症；然而，由于缺乏数据，BTM 无法被纳入骨折风险算法。骨质疏松症治疗后 BTM 的变化可能有助于监测。血清Ⅰ型前胶原氨基端前肽（s-PINP）和血清Ⅰ型胶原羧基端交联肽（s-βCTX）分别被指定为骨质疏松症中骨形成和骨吸收的参考标准标志物；需要进一步研究以常规用于骨质疏松症。BTM 可用于诊断和监测 Pagets 骨病和其他与异常骨形成和/或骨吸收相关的骨骼疾病。需要标准化的患者准备以减轻生物学变异的影响，适当的样本处理和储存对于最小化样本降解非常重要。BTM 之间存在显著的方法差异，正在努力对参考 BTM 进行方法学的标准化。这将有助于制定普遍接受的决策界限和治疗目标。已经为 s-PINP 和 s-βCTX 的一些方法制定了澳大利亚共识参考区间。
