Role of biochemical markers in the management of osteoporosis

Several serum and urine biochemical markers of bone resorption and formatio n have been developed. Biochemical bone markers have been used as intermedi ate end-points in all major studies of anti-osteoporotic therapies. Bone re sorption markers, in particular, may add an independent, predictive value t o the assessment of bone loss and fracture risk. There are also potential a dvantages in monitoring anti-osteoporotic treatment in the short-term in ad dition to bone densitometry, to rapidly identify non-responders to therapy, or non-compliance. Despite these recent advances, until now bone markers h ave simply been very useful research tools, with their clinical utility bei ng limited by intra-individual and diurnal variability. However, the probab ility of the true bone mineral density response to hormone replacement ther apy for the individual patient may be predicted using algorithms based on a spectrum of cut-off bone marker levels with varying false positive and neg ative rates. Thus, the transition of biochemical bone markers into everyday clinical practice may be rapidly approaching.