TY - JOUR
T1 - Clinical utility of bone markers in various diseases
AU - Vlot, M. C.
AU - den Heijer, M.
AU - de Jongh, R. T.
AU - Vervloet, M. G.
AU - Lems, W. F.
AU - de Jonge, R.
AU - Obermayer-Pietsch, B.
AU - Heijboer, A. C.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Measurements of bone markers (BMs) in peripheral blood or urine are a pivotal part of bone research within modern clinical medicine. In recent years the use of BMs increased substantially as they can be useful either to diagnose bone (related) disease and to follow its natural history, but also to monitor the effects of interventions. However, the use of BMs is still complicated mainly due to (pre)analytical variability of these substances, limited accessibility of assays, variable cut-off values in different countries and laboratories and heterogeneous results with regard to clinical implications of measuring BMs in several studies. This review will provide the clinician with a practical guide, based on current evidence, in which circumstances to test which bone markers for optimal diagnostic purposes, in order to improve patient care in different areas of bone diseases including Paget's disease, primary osteoporosis, tumor induced osteomalacia, hypophosphatemic rickets, van Buchem disease, chronic kidney disease, rheumatoid arthritis, neoplasma/multiple myeloma, type 2 diabetes mellitus and primary hyperparathyroidism. The clinician should consider fasting state, recent fractures, aging, menopausal status, concomitant liver and kidney disease when ordering and interpreting BM measurements as these factors might result in misleading BM concentrations. We found that BMs are clearly useful in the current diagnosis of tumor induced osteomalacia, van Buchem disease, Paget's disease and hypophosphatemic rickets. In addition, BMs are useful to monitor disease activity in chronic kidney disease, Paget's disease and are useful to monitor treatment adherence in osteoporosis.
AB - Measurements of bone markers (BMs) in peripheral blood or urine are a pivotal part of bone research within modern clinical medicine. In recent years the use of BMs increased substantially as they can be useful either to diagnose bone (related) disease and to follow its natural history, but also to monitor the effects of interventions. However, the use of BMs is still complicated mainly due to (pre)analytical variability of these substances, limited accessibility of assays, variable cut-off values in different countries and laboratories and heterogeneous results with regard to clinical implications of measuring BMs in several studies. This review will provide the clinician with a practical guide, based on current evidence, in which circumstances to test which bone markers for optimal diagnostic purposes, in order to improve patient care in different areas of bone diseases including Paget's disease, primary osteoporosis, tumor induced osteomalacia, hypophosphatemic rickets, van Buchem disease, chronic kidney disease, rheumatoid arthritis, neoplasma/multiple myeloma, type 2 diabetes mellitus and primary hyperparathyroidism. The clinician should consider fasting state, recent fractures, aging, menopausal status, concomitant liver and kidney disease when ordering and interpreting BM measurements as these factors might result in misleading BM concentrations. We found that BMs are clearly useful in the current diagnosis of tumor induced osteomalacia, van Buchem disease, Paget's disease and hypophosphatemic rickets. In addition, BMs are useful to monitor disease activity in chronic kidney disease, Paget's disease and are useful to monitor treatment adherence in osteoporosis.
KW - BALP
KW - Bone derived hormones
KW - Bone markers
KW - Bone turnover
KW - CTX-I
KW - Clinical utility
KW - FGF23
KW - Hypophosphatemic disease
KW - Metabolic bone disease
KW - Osteoblast
KW - Osteocalcin
KW - Osteoclast
KW - Osteocyte
KW - Osteoporosis
KW - PINP
KW - Paget
KW - Review
KW - Sclerostin
KW - Tumor induced osteomalacia
KW - van Buchem disease
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85049015318&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29920402
UR - http://www.scopus.com/inward/record.url?scp=85049015318&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.bone.2018.06.011
DO - https://doi.org/10.1016/j.bone.2018.06.011
M3 - Review article
C2 - 29920402
SN - 8756-3282
VL - 114
SP - 215
EP - 225
JO - Bone
JF - Bone
ER -