An increasing repertoire of laboratory tests are available for assessing the bone remodeling process. Although these tests have a role in a variety of disease states, their main role is in the management of osteoporosis. Markers of bone remodeling can be measured in serum or urine, and have a number of potential roles in the management of fracture risk: Differences in remodeling between individuals might be related to fracture risk and could be used to target therapy.
- Change in remodeling with therapy could be related to fracture risk reduction
- The choice of therapy could be influenced by knowledge of bone remodeling
- Biochemical therapeutic monitoring may improve patient understanding and therapeutic adherence
Markers of bone remodeling are also useful in a variety of other conditions involving the skeleton, such as Paget’s disease of bone, bone disease in malignancy, disorders of growth and renal bone disease. Other specialised investigations such as parathyroid hormone related peptide (PTHrP), 1,25-dihydroxyvitamin D (calcitriol) and investigations related to phosphate metabolism are available through the SAS network.
- Norfolk & Norwich University Hospital Bone Marker Service
- London Imperial Charing Cross Hospital Bone Marker Service