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Current evidence continues to support the potential for bone turnover markers (BTM) to provide clinically useful information particularly for monitoring the efficacy of osteoporosis treatment. Many of the limitations identified earlier remain, principally in regard to the relationship between BTM and incident fractures. Important data are now available on reference interval values for CTX and PINP across a range of geographic regions and for individual clinical assays. An apparent lack of comparability between current clinical assays for CTX has become evident indicating the possible limitations of combining such data for meta-analyses. Harmonization of units for reporting serum/plasma CTX (ng/L) and PINP (μg/L) is recommended. The development of international collaborations continues with an important initiative to combine BTM results from clinical trials in osteoporosis in a meta-analysis and an assay harmonization program are likely to be beneficial. It is possible that knowledge derived from clinical studies can further enhance fracture risk estimation tools with inclusion of BTM together with other independent risk factors. Further data of the relationships between the clinical assays for CTX and PINP as well as physiological and pre-analytical factors contributing to variability in BTM concentrations are required.

Original publication

DOI

10.1016/j.cca.2016.06.036

Type

Journal article

Journal

Clinica chimica acta; international journal of clinical chemistry

Publication Date

04/2017

Volume

467

Pages

34 - 41

Addresses

School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia. Electronic address: Howard.Morris@sa.gov.au.

Keywords

IFCC-IOF Working Group for Standardisation of Bone Marker Assays (WG-BMA)