Summary
The development of new biochemical markers of bone metabolism has greatly enriched the array of analytes used in the assessment of skeletal pathologies. When applied and interpreted correctly, these indices may be useful in the work-up of patients with metabolic or malignant bone disease.
Although they are not suitable for establishing the diagnosis of osteoporosis itself, they may, in selected cases, provide additional information on fracture risk.
Bone markers may also be used to assess disease activity (e.g, in Paget’s disease of bone) and to monitor therapeutic response and efficacy in patients receiving treatment.
One should always bear in mind, however, that (i) abnormalities in molecular markers of bone metabolism are never disease-specific; (ii) most data on the utility of these markers have been obtained from research trials and few attempts have been made to translate the results to the clinical situation facing the individual patient; and (iii) the “real-life” variability of bone markers can be significant and needs consideration before any decision is made on the basis of marker results.