Abstract

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.

Original languageEnglish
Pages (from-to)215-225
Number of pages11
JournalBone
Volume114
DOIs
Publication statusPublished - 1 Sep 2018

Cite this

@article{5b4f4d01464b4df78db3167b1a98413b,
title = "Clinical utility of bone markers in various diseases",
abstract = "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.",
keywords = "BALP, Bone derived hormones, Bone markers, Bone turnover, Clinical utility, CTX-I, FGF23, Hypophosphatemic disease, Metabolic bone disease, Osteoblast, Osteocalcin, Osteoclast, Osteocyte, Osteoporosis, Paget, PINP, Review, Sclerostin, Tumor induced osteomalacia, van Buchem disease",
author = "Vlot, {M. C.} and {den Heijer}, M. and {de Jongh}, {R. T.} and Vervloet, {M. G.} and Lems, {W. F.} and {de Jonge}, R. and B. Obermayer-Pietsch and Heijboer, {A. C.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1016/j.bone.2018.06.011",
language = "English",
volume = "114",
pages = "215--225",
journal = "Bone",
issn = "8756-3282",
publisher = "Elsevier Inc.",

}

Clinical utility of bone markers in various diseases. / Vlot, M. C.; den Heijer, M.; de Jongh, R. T.; Vervloet, M. G.; Lems, W. F.; de Jonge, R.; Obermayer-Pietsch, B.; Heijboer, A. C.

In: Bone, Vol. 114, 01.09.2018, p. 215-225.

Research output: Contribution to journalReview articleAcademicpeer-review

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 - Clinical utility

KW - CTX-I

KW - FGF23

KW - Hypophosphatemic disease

KW - Metabolic bone disease

KW - Osteoblast

KW - Osteocalcin

KW - Osteoclast

KW - Osteocyte

KW - Osteoporosis

KW - Paget

KW - PINP

KW - Review

KW - Sclerostin

KW - Tumor induced osteomalacia

KW - van Buchem disease

UR - http://www.scopus.com/inward/record.url?scp=85049015318&partnerID=8YFLogxK

U2 - 10.1016/j.bone.2018.06.011

DO - 10.1016/j.bone.2018.06.011

M3 - Review article

VL - 114

SP - 215

EP - 225

JO - Bone

JF - Bone

SN - 8756-3282

ER -