Clinical Use of Bone Turnover Markers

Bauer, Douglas C.

doi:10.1001/jama.2019.9372

Cited by 21 publications

(26 citation statements)

References 10 publications

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“…As already mentioned in the Introduction of this article, osteoporosis has been increasingly studied over the years as it is a skeletal disease leading to structural deterioration of bone tissue and especially when related fractures occur, it significantly interferes with the quality of life (35)(36)(37). Besides, concern has grown to identify effective strategies for managing osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Physical Activity on Bone Biomarkers in People With Osteoporosis: A Systematic Review

et al. 2020

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Background: Bone imbalance between anabolic and catabolic processes at the level of remodeling unit due to the prevalence of resorbing activity, represents a health problem of aging. The consequence is the negative balance of bone turnover that can lead to osteoporosis. Physical activity (PA) can play a central role in the comprehensive management of osteoporosis, since it induces the anabolism of bone tissue. Bone turnover biomarkers, reflecting the cellular activity linked to bone metabolism, can represent an evaluation tool to assess the efficacy of PA in the osteoporotic population. The aim of this systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was to investigate the effects of PA interventions on bone biomarkers in people with osteoporosis. Methods: A comprehensive literature search of electronic databases was conducted through PubMed, Cochrane, Cinahl, Embase, Trip, to find randomized controlled trials (RCTs) investigating the topic of PA and bone turnover biomarkers in the osteoporosis population. In accordance with the Cochrane risk-of-bias tool, the quality of each study was assessed. Results: Out of 992 identified articles, 136 full texts were screened. Only three RTCs matched the eligibility criteria. In one study, sub-maximal aerobic exercise improved Bone-specific alkaline phosphatase (bone formation biomarker) and Amino-terminal Crosslinked Telopeptide of type 1 collagen (bone resorption biomarker) in osteoporotic women. The other two studies showed a positive effect on total alkaline phosphatase (a non-specific bone formation biomarker) in women with osteoporosis. Conclusion: The systematic review revealed possible exercise benefits in terms of improving bone formation and decreasing bone resorption biomarkers in the osteoporotic population. However, these results should be interpreted with caution, especially due to the limited number and poor quality of the studies included. Further research is needed to estimate the influence of PA on bone biomarkers in the osteoporosis management.

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Section: Discussionmentioning

confidence: 99%

The Effect of Physical Activity on Bone Biomarkers in People With Osteoporosis: A Systematic Review

et al. 2020

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“…Resorption rate exceeding formation rate leads to osteoporosis, which is manifested as low bone mineral density (BMD) and deteriorated bone microstructures. Bone turnover biomarkers are the landmark substances of biochemical products produced during the ongoing process of bone resorption or bone formation ( Bauer, 2019 ). Bone formation markers, including bone isoforms of alkaline phosphatase (BALP) and osteocalcin (OCN), reflect osteoblast activity, while tartrate-resistant acid phosphatase (TRACP) is considered to reflect amount of osteoclasts ( Fontalis and Eastell, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

The Ginsenoside Exhibits Antiosteoporosis Effects in Ketogenic-Diet-Induced Osteoporosis via Rebalancing Bone Turnover

Liu

Zhou²,

Zhou

et al. 2021

Front. Pharmacol.

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Ginsenoside is widely used in China for therapeutic and healthcare practice. Ginsenoside-Rb2 shows the antiosteoporosis effects in ovariectomized rodents. However, the protective effects on osteoporosis induced by ketogenic diet (KD) remain unknown. Therefore, this study aimed at evaluating the effects of ginsenoside-Rb2 on KD-induced osteoporosis. Thirty mice were randomly divided into three groups: sham, KD, and KD + Rb2. Bone microstructures, biomechanical properties, concentrations of serum bone alkaline phosphatase (BALP) and tartrate-resistant acid phosphatase (TRACP), and protein expression of osteocalcin (OCN), peroxisome proliferation-activated receptor γ (PPAR-γ), cathepsin K, and TRAP were evaluated after a 12-week intervention. The results show that KD induced significant bone loss and biomechanical impairment. Ginsenoside-Rb2 attenuated significant bone loss and maintained biomechanics in cancellous bone. The bone volume fraction increased from 2.3 to 6.0% in the KD + Rb2 group than that in the KD group. Meanwhile, ginsenoside-Rb2 effectively maintained biomechanical strengths in cancellous bone, increased serum BALP and decreased TRACP, and upregulated OCN and downregulated TRAP, PPAR-γ, and cathepsin K in the KD mice. This study demonstrated that ginsenoside-Rb2 retards bone loss and maintains biomechanics with KD. The underlying mechanism might be that ginsenoside-Rb2 inhibits bone resorption process and induces osteogenic differentiation, providing evidence for ginsenoside as being an alternative option for osteoporosis induced by KD.

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“…Lastly, the clinical relevance of these findings is unclear. Although current guidelines do not include measurement of BTMs to assess need for treatment of osteoporosis (Bauer, ), BTMs have been used to inform treatment strategy and assess conditions that affect bone metabolism (Jain and Camacho, ). The negative association between alcohol and bone formation would be of interest to PLWH concerned about modifiable risk factors for poor bone health.…”

Section: Discussionmentioning

confidence: 99%

Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder

Kim

Ventura

Winter

et al. 2020

Alcoholism Clin & Exp Res

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Background: Although unhealthy alcohol use and low bone density are prevalent among people living with HIV (PLWH), it is not clear whether alcohol use is associated with bone turnover markers (BTMs), and if so, at what quantity and frequency. The study objective was to examine the association between alcohol and BTMs in PLWH with substance use disorder.Methods: We studied a prospective cohort recruited from 2 HIV clinics who met criteria for DSM-IV substance dependence or reported ever injection drug use. Outcomes were BTM of (i) bone formation (serum procollagen type 1 N-terminal propeptide [P1NP]) and (ii) bone resorption (serum Ctelopeptide type 1 collagen [CTx]). Alcohol consumption measures included (i) mean number of drinks/ d (Timeline Follow-Back [TLFB]) (primary predictor), (ii) any alcohol use on ≥20 of the past 30 days, and phosphatidylethanol (PEth), a biomarker of recent alcohol consumption. Linear regression analysis examined associations between (i) each alcohol measure and each BTM and (ii) change in alcohol and change in BTM over 12 months.Results: Among 198 participants, baseline characteristics were as follows: The median age was 50 years; 38% were female; 93% were prescribed antiretroviral medications; 13% had ≥20 drinking days/month; mean drinks/day was 1.93 (SD 3.89); change in mean drinks/day was À0.42 (SD 4.18); mean P1NP was 73.1 ng/ml (SD 34.5); and mean CTx was 0.36 ng/ml (SD 0.34). Higher drinks/day was significantly associated with lower P1NP (slope À1.09 ng/ml; 95% confidence interval [CI] À1.94, À0.23, per each additional drink). On average, those who drank on ≥ 20 days/month had lower P1NP (À15.45 ng/ml; 95% CI: À26.23, À4.67) than those who did not. Similarly, PEth level ≥ 8ng/ml was associated with lower P1NP. An increase in drinks/d was associated with a decrease in P1NP nonsignificantly (À1.14; 95% CI: À2.40, +0.12; p = 0.08, per each additional drink). No significant associations were detected between either alcohol measure and CTx.Conclusions: In this sample of PLWH with substance use disorder, greater alcohol consumption was associated with lower serum levels of bone formation markers.

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Clinical Use of Bone Turnover Markers

Cited by 21 publications

References 10 publications

The Effect of Physical Activity on Bone Biomarkers in People With Osteoporosis: A Systematic Review

The Effect of Physical Activity on Bone Biomarkers in People With Osteoporosis: A Systematic Review

The Ginsenoside Exhibits Antiosteoporosis Effects in Ketogenic-Diet-Induced Osteoporosis via Rebalancing Bone Turnover

Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder

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