Department of Clinical Chemistry, University of Liege.
Department of Nephrology, Dialysis and Transplantation, CHU de Liege, Liege, Belgium.
Curr Opin Endocrinol Diabetes Obes. 2024 Aug 1;31(4):149-156. doi: 10.1097/MED.0000000000000869. Epub 2024 May 27.
Disturbances in mineral and bone metabolism occurring in osteoporosis and chronic kidney disease-associated osteoporosis place patients at high risk of fracture making these conditions a major public health concern. Due to the limited use of bone histomorphometry in clinical practice, the gold standard for assessing bone turnover, extensive efforts have been made to identify bone turnover markers (BTMs) as noninvasive surrogates. Since the identification of certain commonly used markers several decades ago, considerable experience has been acquired regarding their clinical utility in such bone disorders.
Mounting evidence suggested that BTMs represent a simple, low-risk, rapid and convenient way to obtain data on the skeletal health and that they may be useful in guiding therapeutic choices and monitoring the response to treatment.
BTMs could provide clinicians with useful information, independent from, and often complementary to bone mineral density (BMD) measurements. They have proven valuable for monitoring the effectiveness of osteoporosis therapy, as well as promising for discriminating low and high turnover states. Improved performance is observed when BTMs are combined, which may be useful for selecting treatments for chronic kidney disease-bone mineral disorders (CKD-MBD).
骨质疏松症和慢性肾脏病相关骨质疏松症中发生的矿物质和骨代谢紊乱使患者骨折风险增加，这些情况成为主要的公共卫生关注点。由于骨组织形态计量学在临床实践中的应用有限，作为评估骨转换的金标准，人们广泛努力寻找骨转换标志物（BTM）作为非侵入性替代物。自几十年前确定某些常用标志物以来，人们已经获得了关于它们在这些骨骼疾病中的临床应用的大量经验。
越来越多的证据表明，BTM 代表了一种简单、低风险、快速和方便的获取骨骼健康数据的方法，它们可能有助于指导治疗选择和监测治疗反应。
BTM 可以为临床医生提供有用的信息，独立于且通常补充骨矿物质密度（BMD）测量。它们已被证明可用于监测骨质疏松症治疗的效果，并且在区分低转换和高转换状态方面具有前景。当 BTM 联合使用时，观察到性能得到改善，这可能有助于为慢性肾脏病-骨矿物质紊乱（CKD-MBD）选择治疗方法。
