Description

A number of new assays have recently been developed which allow us to study the processes of bone resorption and bone formation. The greater specificity of these assays for bone means that they may be suitable for the study of the small changes in bone turnover that occur in osteoporosis. These markers include osteocalcin, the bone isoform of alkaline phosphatase, and pyridinium crosslinks of type I collagen. These markers are being proposed for use in the prediction of rate of bone loss and the prediction of fractures, but the evidence for this is not strong enough yet for the use in individual patients. However, they are a promising approach for the monitoring of therapy with bisphosphonates and hormone replacement in patients with osteoporosis and have the advantage over the traditional test, bone mineral density, in that they decrease in 3 to 6 months at the
onset of therapy and can be measured by standard laboratory tests.