Author
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GALLAGHER, SANDRA - UNIV. OF NORTH DAKOTA |
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Submitted to: Medical Lab Observer
Publication Type: Peer Reviewed Journal Publication Acceptance Date: 8/1/1997 Publication Date: N/A Citation: N/A Interpretive Summary: Osteoporosis is a major healthy problem and is becoming increasingly important in our aging society. Osteoporosis is a common condition affecting as many as 25 million individuals in the United States. Osteoporosis is a silent disease that progresses without an outward sign, until a fracture results. The cause of osteoporosis is not known but there are known risk factors that increase the likelihood of developing osteoporosis. These risk factors can be divided into three categories: genetic, hormone related, and lifestyle related. Women are about four times more likely to develop osteoporosis than men because they generally have thinner, lighter bones and because rapid bone loss occurs at menopause. There are three diagnostic procedures that are available for evaluating metabolic bone disease: bone density, bone biopsies, and biochemical markers of bone turnover. Bone density measurements are essential for diagnosing osteoporosis. Bone biopsies are invasive procedures and can not be used routinely in the management of this disease. Accordingly, there has been a great effort in recent years to develop biochemical markers of bone turnover. This paper presents a synopsis of biochemical test that are available for the diagnosis, treatment, and prevention of osteoporosis. These markers are of unequal specificity and sensitivity and none of these markers are disease specific. But used together with other diagnostic procedures, they may give the physician and the patient more information on the health of bones so that prevention and/or the slowing down of the progression of the disease is possible. Technical Abstract: Osteoporosis is a major health problem which may affect as many as 25 million individuals in the United States. There are three diagnostic procedures available for evaluating metabolic bone diseases: bone density, bone biopsies, and biochemical markers of bone turnover. Bone biopsies are invasive and can't be routinely used in the management of patients with osteoporosis. Bone density measurements are essential for the diagnoses of osteoporosis. There are four widely used methods to measure bone density and mass: Single photon absorptiometry, dual-photon absorptionmetry, quantitative computed tomography and dual x-ray absorptionmetry (DXA). DXA is the method of choice because it can offer the advantage of the shortest scan times and the lowest radiation exposure. Biochemical markers are important because they can be used more frequently to monitor the impact of treatment. The rate of formation or degradation can be assessed either by measuring enzymatic activity of bone-forming cells or by measuring bone matrix components released during formation or resorption. Procedures that are available for the measurement of formation markers include: total and bone specific alkaline phosphatase, osteocalcin, and procollagen I extension peptides. Bone resorption markers available are: urinary calcium, hydroxyproline, hydroxylysine glycosides, N-telopeptides, pyridinium crosslinks and plasma tartrate resistant acid phosphatase. None of these markers is disease specific, but a given marker may be more sensitive to assess bone turnover in one metabolic bone disease than in another. |
