Word Document format Biochemical markers of bone formation and resorption provide an index of the overall rate of skeletal turnover. Recently, new specific markers of bone turnover with increased specificity and sensitivity were developed. Changes in most biochemical markers reflect modulation of bone turnover in various metabolic skeletal diseases including postmenopausal osteoporosis.
Most markers discriminate well between normal women and patients with postmenopausal osteoporosis.
However, the long-term variability, over periods of months, ranges between 15 to almost 30 percent for the various markers. Although biochemical markers cannot quantify bone mass, it predicts the rate of bone loss, especially if markers of bone resorption and formation are being used together. There is emerging evidence that increased rates of bone turnover as measured by the biochemical markers can predict fracture risk independent of bone density. There are observations that show an increase response to antiresorptive treatment in patients with higher turnover rates. Treatment with bisphosphonates caused a marked decrease in the biochemical parameters of bone turnover with resorption markers decreasing eartier than formation markers.