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Cureus 2021 Apr 13;13(4):e14479. Epub 2021 Apr 13.

Pathology & Laboratory Medicine, Aga Khan University Hospital, Karachi, PAK.

Introduction Hepatic osteodystrophy is an osteoporotic bone disease that occurs in chronic liver disease patients. The global prevalence of osteoporosis in patients with chronic liver disease is 30% to 40%. The pathogenesis of hepatic bone disease is not clear, but it occurs due to unstable bone remodeling with increased bone resorption and decreases bone formation. Read More

J Hand Surg Am 2021 Apr 22. Epub 2021 Apr 22.

Orthopaedics, USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences. Electronic address:

Purpose: The objective of this study was to analyze changes in serum markers of bone turnover across multiple decades in osteoporotic women compared with nonosteoporotic controls, to determine their utility as potential predictors for osteoporosis. Early prediction of those at risk for osteoporosis can enable early intervention before the irreversible loss of critical bone mass.

Methods: Serum samples were obtained from 20 women given the diagnosis of osteoporosis after age 46 years and 20 age-matched women with normal bone mineral density from 4 time points in their life (ages 25-31, 32-38, 39-45, and 46-60 years). Read More

JOR Spine 2021 Mar 25;4(1):e1132. Epub 2020 Nov 25.

Research & Development Radius Health, Inc. Waltham Massachusetts USA.

Background: Abaloparatide is a parathyroid hormone receptor agonist that increases bone formation and reduces vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis. Animal studies indicate abaloparatide stimulates vertebral bone formation and enhances bony bridging and biomechanical stability of fracture calluses.

Aims: The current study is evaluating the potential utility for abaloparatide as an adjunct therapy for spinal fusions. Read More

Osteoporos Int 2021 May 24;32(5):831-840. Epub 2020 Nov 24.

Metabolic Bone Centre, Northern General Hospital, Sheffield, UK.

The use of bone turnover marker (BTM) testing for patients with osteoporosis in the USA has not been well characterized. This retrospective US-based real-world data study found BTM testing has some association with treatment decision-making and lower fracture risk in patients with presumed osteoporosis, supporting its use in clinical practice.

Introduction: The purpose of this study was to characterize bone turnover marker (BTM) testing patterns and estimate their clinical utility in treatment decision-making and fragility fracture risk in patients with osteoporosis using a retrospective claims database. Read More

Int J Mol Sci 2020 Sep 21;21(18). Epub 2020 Sep 21.

Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.

Osteoporosis is a multifactorial skeletal disease that is associated with both bone mass decline and microstructure damage. The fragility fractures-especially those affecting the femur-that embody the clinical manifestation of this pathology continue to be a great medical and socioeconomic challenge worldwide. The currently available diagnostic tools, such as dual energy X-ray absorptiometry, Fracture Risk Assessment Tool (FRAX) score, and bone turnover markers, show limited specificity and sensitivity; therefore, the identification of alternative approaches is necessary. Read More

Trop Doct 2020 Jul 16;50(3):228-232. Epub 2020 May 16.

Associate Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India.

Osteoporosis is characterised by low bone mineral density (BMD) and is a significant public health problem in India. This cross-sectional study was done to assess the relationship between various anthropometric measures and BMD in 308 rural dwelling South Indian postmenopausal women. Anthropometric variables such as weight, body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured. Read More

Bone 2020 07 28;136:115336. Epub 2020 Mar 28.

Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK.

Oral Bisphosphonates (BPs) are the mainstay of osteoporotic treatment, however long-term adherence remains a challenge, primarily owing to the chronic character of the disease and the regimen complexity. Poor compliance has been shown to have a clear link to fracture risk. The role of bone turnover markers (BTMs) as a tool to ascertain adherence and response to therapy is supported by their rapid response to treatment; a decrease in values is witnessed within days or weeks of commencing treatment. Read More

J Clin Lab Anal 2020 Jun 17;34(6):e23223. Epub 2020 Feb 17.

The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Background: Postmenopausal osteoporosis (PMOP) is an estrogen deficiency-induced skeletal disorder. Bone mineral density (BMD) testing is the gold standard for diagnosing osteoporosis. However, its sensitivity for fracture risk assessment is low. Read More

Breast Cancer Res Treat 2020 Feb 7;180(1):187-195. Epub 2020 Jan 7.

Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.

Purpose: Osteoporosis and fragility fracture are major bone toxicities of aromatase inhibitors (AIs) for postmenopausal hormone receptor-positive breast cancer. Except for a few small studies on bone turnover markers and reduced bone mineral density after AI treatment, data on the associations of bone markers and risk of osteoporosis or fracture from prospective studies are lacking.

Methods: In a prospective study of 1709 women on AIs, two bone turnover markers, BALP and TRACP, and two bone regulatory markers, RANKL and OPG, were measured and examined in relation to risk of osteoporosis and fragility fractures during a median follow-up time of 6. Read More

Adv Ther 2019 10 22;36(10):2811-2824. Epub 2019 Aug 22.

University of Liège, CHU de Liège, Liège, Belgium.

Introduction: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication.

Methods: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Read More

Clin Endocrinol (Oxf) 2019 09 18;91(3):391-399. Epub 2019 Jun 18.

Clinical Chemistry, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.

Context: Bone loss is accelerated in the late perimenopause and early menopause. The date of the final menstrual period cannot be stated until 1 year after it has ended, and at that time, most of the rapid bone loss phase will have elapsed. Therefore, early detection of bone loss is crucial. Read More

ACS Nano 2019 05 13;13(5):5451-5464. Epub 2019 May 13.

Chemistry in Pharmaceutical Sciences, School of Pharmacy . Universidad Complutense de Madrid , Spain. Instituto de Investigación Sanitaria Hospital 12 de Octubre i + 12, Plaza de Ramón y Cajal s/n , E-28040 Madrid , Spain.

Osteoporosis is the most common disease involving bone degeneration. Current clinical treatments are not able to offer a satisfying curative effect, so the development of effective treatments is desired. Gene silencing through siRNA delivery has gained great attention as a potential treatment in bone diseases. Read More

Curr Opin Endocrinol Diabetes Obes 2019 06;26(3):125-132

Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.

Purpose Of Review: Adrenal tumors occur in 5% of population with higher prevalence in elderly. Patients with adrenal tumors present with overt hormonal excess in up to 15% of cases, and mild autonomous cortisol secretion in 30-40% of cases. Overt Cushing syndrome, mild autonomous cortisol secretion, pheochromocytoma, and primary aldosteronism have been associated with higher cardiovascular morbidity and mortality. Read More

Turk J Urol 2019 07 20;45(4):245-253. Epub 2019 Feb 20.

King George Medical University (KGMU), Lucknow, India.

Objective: Maintaining the optimum bone health is one of the important concerns in patients with prostate cancer, but it usually remains neglected. Failure to screen these patients is detrimental to both the length and the quality of life. The estimation of bone mineral density (BMD) and more recently the World Health Organization's fracture risk assessment (FRAX) algorithm in appropriate patients is recommended by several specialty organizations/associations at the time of instituting androgen deprivation therapy (ADT) for metastatic and high-risk individuals. Read More

Osteoporos Int 2019 Apr 6;30(4):917-922. Epub 2019 Jan 6.

Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK.

Bone markers may be useful to monitor response to treatment withdrawal in osteoporosis. We used two criteria for investigating the change in BTMs after withdrawal of bisphosphonate treatment. A larger increase in BTMs was associated with greater bone loss. Read More

Curr Opin Endocrinol Diabetes Obes 2018 12;25(6):366-372

Loyola University Medical Center, Maywood, Illinois, USA.

Purpose Of Review: Osteoporosis is a common public health problem that is often undertreated and underdiagnosed. The clinical management of osteoporosis is often reactionary to devastating fracture events. Bone turnover markers may improve the ease and rapidity at which osteoporosis is monitored and treated. Read More

Burns 2018 12 1;44(8):1863-1869. Epub 2018 Aug 1.

Shriners Hospital for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX 77555, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA. Electronic address:

Severe burns in children can lead to growth delays, bone loss, and wasting of lean body mass and muscle with subsequent long-term effects such as osteoporosis. The following review examines 11 randomized, placebo-controlled, prospective clinical trials in pediatric burns between 1995 and 2017. These studies included approximately 250 burned children, and they were conducted to evaluate the impact of severe burn on markers of bone formation and bone metabolism. Read More

EJIFCC 2018 Jul 11;29(2):117-128. Epub 2018 Jul 11.

Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Hungary.

With an aging population, there is a marked increase in prevalence of metabolic bone diseases, especially osteoporosis. Perhaps the most dreaded complication of metabolic bone disease, fractures typically impose a huge burden on the ailing body and are associated with high co-morbidity and mortality. The consequent public health and socioeconomic burden warrant timely diagnosis, treatment and follow-up of these disorders. Read More

J Bone Miner Res 2018 07 19;33(7):1199-1208. Epub 2018 Jun 19.

Departments of Medicine and Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.

Current guidelines recommend that serum C-terminal telopeptide of type I collagen (CTX) and serum procollagen type 1 aminoterminal propeptide (PINP), measured by standardized assays, be used as reference markers in observational and interventional studies. However, there are limited data to determine whether serum CTX and PINP are associated with hip fracture risk among postmenopausal women. We determined the associations of serum CTX and serum PINP with hip fracture risk among postmenopausal women aged 50 to 79 years at baseline. Read More

Bone 2018 09 18;114:215-225. Epub 2018 Jun 18.

Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; Department of Clinical Chemistry, Laboratory of Endocrinology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. Electronic address:

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. Read More

J Bone Metab 2018 May 31;25(2):73-78. Epub 2018 May 31.

Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Bone turnover markers (BTMs) are released during bone remodeling and are thought to reflect the metabolic activity of bone at the cellular level. This review examines BTM as a biological response marker for monitoring future fracture prediction and fracture healing processes. Substantial evidence has been of high value to investigate the use of BTM in fracture risk prediction; nevertheless, the conclusions of some studies are inconsistent due to their large variability. Read More

JCI Insight 2018 06 7;3(11). Epub 2018 Jun 7.

Department of Anatomy & Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

The WNT pathway has become an attractive target for skeletal therapies. High-bone-mass phenotypes in patients with loss-of-function mutations in the LRP5/6 inhibitor Sost (sclerosteosis), or in its downstream enhancer region (van Buchem disease), highlight the utility of targeting Sost/sclerostin to improve bone properties. Sclerostin-neutralizing antibody is highly osteoanabolic in animal models and in human clinical trials, but antibody-based inhibition of another potent LRP5/6 antagonist, Dkk1, is largely inefficacious for building bone in the unperturbed adult skeleton. Read More

J Dent Res 2018 08 4;97(9):1031-1038. Epub 2018 Apr 4.

1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA.

Alveolar bone is a mechanosensitive tissue that provides structural support for teeth. Alveolar bone loss is common with aging, menopause, tooth loss, and periodontitis and can lead to additional tooth loss, reduced denture fixation, and challenges in placing dental implants. The current studies suggest that sclerostin and DKK1, which are established osteocyte-derived inhibitors of bone formation, contribute to alveolar bone loss associated with estrogen ablation and edentulism in rats. Read More

Sci Rep 2018 03 20;8(1):4867. Epub 2018 Mar 20.

Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria.

The assessment of bone quality and the prediction of fracture risk in idiopathic osteoporosis (IOP) are complex prospects as bone mineral density (BMD) and bone turnover markers (BTM) do not indicate fracture-risk. MicroRNAs (miRNAs) are promising new biomarkers for bone diseases, but the current understanding of the biological information contained in the variability of miRNAs is limited. Here, we investigated the association between serum-levels of 19 miRNA biomarkers of idiopathic osteoporosis to bone microstructure and bone histomorphometry based upon bone biopsies and µCT (9. Read More

Clin Chim Acta 2018 Jun 12;481:161-170. Epub 2018 Mar 12.

Department of Clinical Biochemistry, PathWest Fiona Stanley Hospital Network, Murdoch, Western Australia, Australia. Electronic address:

Bone turnover marker (BTMs) concentrations in blood and urine reflect bone-remodelling activity, and may be useful adjuncts in the diagnosis and management of metabolic bone diseases. Newer biomarkers, mainly bone regulatory proteins, are currently being investigated to elucidate their role in bone metabolism and disease and may in future be useful in clinical diagnosis and management of metabolic bone disease. BTM concentrations increase around menopause in women, and at a population level the degree of increase in BTMs reflect bone loss. Read More

PLoS One 2018 15;13(3):e0193846. Epub 2018 Mar 15.

Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.

Introduction: The clinical utility of denosumab for the treatment of glucocorticoid-induced osteoporosis (GIOP) has yet to be established. This study aimed to compare the effects of denosumab on bone mineral density (BMD) and bone turnover markers to those of alendronate in patients with GIOP.

Methods: A prospective, single-center study of 32 patients (18 men; median age, 66. Read More

Am J Transl Res 2017 15;9(7):3517-3527. Epub 2017 Jul 15.

Nordic Bioscience (Beijing) Ltd.Beijing, China.

The clinical utility of Traditional Chinese Medicine (TCM) herbs/roots extracts in osteoporosis (OP) and osteoarthritis (OA) has been described in multiple reports, but there have been few studies of TCM for preventing bone loss and cartilage degradation simultaneously. Six-month-old female Sprague-Dawley rats each were subjected to ovariectomized (OVX) or sham surgery and treated orally once daily with herbal extracts or vehicle. Body weight was recorded weekly, and blood samples were collected from fasting animals at different time points. Read More

Curr Drug Targets 2018 ;19(5):451-459

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.

Background: Osteoporosis is a debilitating disease characterized by bone micro-architecture degradation contributing to fragility fractures. Currently, determining bone mineral density (BMD) via dual-energy X-ray absorptiometry (DXA) is the most reliable form of diagnosing osteoporosis and managing pharmacological treatment regimens. However, changes in BMD occur slowly (i. Read More

Endocr Rev 2017 08;38(4):325-350

Division of Endocrinology and Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, Minnesota 55905.

Cathepsin K is a cysteine protease member of the cathepsin lysosomal protease family. Although cathepsin K is highly expressed in osteoclasts, lower levels of cathepsin K are also found in a variety of other tissues. Secretion of cathepsin K from the osteoclast into the sealed osteoclast-bone cell interface results in efficient degradation of type I collagen. Read More