BTM levels can vary across the 24-hour period particularly associated with food intake. There is a large biological variability depending on the status of the subject including seasonality, sex, age and menopausal or disease status. Analytical variability can arise from assays from different manufacturers. Pre-analytical variation arises from the use of serum versus plasma samples or the urine collection procedure. A major limitation for their clinical usefulness is their marked variability. This marker therefore is highly specific for bone resorption. For example the assay for C-telopeptide fragments of collagen type I a1 chains (serum Crosslaps (ß-CTX)) is specific for not only the cross-linking of type 1 collagen between lysine residues in adjacent type I collagen molecules but also for the isomerization of the arginyl peptide to the β-form which can only take place in the mature collagen of bone. The specificity of BTMs for bone cell activities has markedly increased over recent times. Their role for providing prognostic information on risk of fracture is uncertain however. Recent evidence confirms their usefulness for monitoring response to antiresorptive therapies for osteoporosis. Robust assays for many markers have been adapted to automated biochemical platforms making them rapidly and cost-effectively available in clinical laboratories. They divide into two main categories, markers of bone cells and type I collagen formation or breakdown products. University of South Australia and SA Pathology, Adelaide, South Australia, AustraliaĬhair, IFCC-IOF WG for Standardisation of Bone Marker AssaysĪ wide range of biochemical markers provide information on the activities of bone cells, largely osteoclasts and osteoblasts, commonly termed bone turnover markers (BTM).

Wednesday, September 21 st, 2016 Pre-congress symposium Clinical utility of bone markers measurement in metabolic diseases Invited Speakers Clinical usefulness of bone turnover marker levels in osteoporosis: 2016 update

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