Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Harjit Pal Bhattoa, Samuel Vasikaran, Ioulia Trifonidi, Georgia Kapoula, Giovanni Lombardi, Niklas Rye Jørgensen, Richard Pikner, Masakazu Miura, Roland Chapurlat, Mickael Hiligsmann, Mathias Haarhaus, Pieter Evenepoel, Hanne Skou Jørgensen, Markus Herrmann, Jean-Marc Kaufman, Patricia Clark, Şansın Tuzun, Nasser Al-Daghri, Stuart Silverman, Majed S Alokail, Sif Ormarsdóttir, María Concepción Prieto Yerro, Radmila Matijevic, Andrea Laslop, Mario Miguel Coelho da Silva Rosa, Leith Zakraoui, Nansa Burlet, Eugene McCloskey, Nicholas C Harvey, Régis P Radermecker, Maria Fusaro, Carla Torre, John A Kanis, René Rizzoli, Jean-Yves Reginster, Konstantinos Makris, Etienne Cavalier
{"title":"Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).","authors":"Harjit Pal Bhattoa, Samuel Vasikaran, Ioulia Trifonidi, Georgia Kapoula, Giovanni Lombardi, Niklas Rye Jørgensen, Richard Pikner, Masakazu Miura, Roland Chapurlat, Mickael Hiligsmann, Mathias Haarhaus, Pieter Evenepoel, Hanne Skou Jørgensen, Markus Herrmann, Jean-Marc Kaufman, Patricia Clark, Şansın Tuzun, Nasser Al-Daghri, Stuart Silverman, Majed S Alokail, Sif Ormarsdóttir, María Concepción Prieto Yerro, Radmila Matijevic, Andrea Laslop, Mario Miguel Coelho da Silva Rosa, Leith Zakraoui, Nansa Burlet, Eugene McCloskey, Nicholas C Harvey, Régis P Radermecker, Maria Fusaro, Carla Torre, John A Kanis, René Rizzoli, Jean-Yves Reginster, Konstantinos Makris, Etienne Cavalier","doi":"10.1007/s00198-025-07422-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) have proposed procollagen type I N propeptide (PINP) and β isomerized C-terminal telopeptide of type I collagen (β-CTX-I) as reference bone turnover markers (BTMs) for osteoporosis. This report examines the published literature since the 2011 IOF-IFCC position paper in order to determine the clinical potential of the reference BTMs and newer markers for the prediction of fracture risk and monitoring the treatment of osteoporosis.</p><p><strong>Methods: </strong>Evidence for the relationship between BTMs and subsequent fractures was gathered from prospective studies through literature review of the Medline database from years 2011 to May 2024. The impact of treatment on BTMs was also studied by examining publications in that period. Studies of the accuracy of BTMs in the assessment of bone turnover in the setting of advanced chronic kidney disease were also examined.</p><p><strong>Results: </strong>Increased BTM concentrations are associated with higher fracture risk in postmenopausal women. PINP and β-CTX-I measured in blood are associated with fracture risk but their interaction with other risk factors has not been sufficiently studied limiting their incorporation into fracture risk algorithms. Treatment-induced changes in PINP and β-CTX-I account for a substantial proportion of fracture risk reduction and are useful for improving adherence; they are recommended for inclusion in studies to examine adherence in individual patients. However, total PINP (tPINP) and β-CTX-I may be elevated in CKD due to renal retention. Bone alkaline phosphatase (BALP), intact PINP (iPINP), and tartrate resistant acid phosphatase 5b (TRACP5b) show the most promise in discriminating high and low turnover bone diseases in patients with advanced CKD and for predicting fracture risk, monitoring treatment response, and assessing the risk of treatment-related complications.</p><p><strong>Conclusion: </strong>We re-affirm the use of serum/plasma tPINP and plasma β-CTX-I as reference BTMs with appropriate patient preparation and sample handling and measurement by standardized/harmonized assays in clinical studies to accumulate further data, and for monitoring treatment of osteoporosis in the setting of normal renal function in clinical practice. BALP and TRACP5b, measured by standardized assays, are recommended as reference BTMs for CKD-associated osteoporosis and should be included in observational and intervention studies to ascertain their utility for risk-evaluation, treatment initiation, and assessment of treatment response in CKD-associated osteoporosis.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Osteoporosis International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00198-025-07422-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: The International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) have proposed procollagen type I N propeptide (PINP) and β isomerized C-terminal telopeptide of type I collagen (β-CTX-I) as reference bone turnover markers (BTMs) for osteoporosis. This report examines the published literature since the 2011 IOF-IFCC position paper in order to determine the clinical potential of the reference BTMs and newer markers for the prediction of fracture risk and monitoring the treatment of osteoporosis.

Methods: Evidence for the relationship between BTMs and subsequent fractures was gathered from prospective studies through literature review of the Medline database from years 2011 to May 2024. The impact of treatment on BTMs was also studied by examining publications in that period. Studies of the accuracy of BTMs in the assessment of bone turnover in the setting of advanced chronic kidney disease were also examined.

Results: Increased BTM concentrations are associated with higher fracture risk in postmenopausal women. PINP and β-CTX-I measured in blood are associated with fracture risk but their interaction with other risk factors has not been sufficiently studied limiting their incorporation into fracture risk algorithms. Treatment-induced changes in PINP and β-CTX-I account for a substantial proportion of fracture risk reduction and are useful for improving adherence; they are recommended for inclusion in studies to examine adherence in individual patients. However, total PINP (tPINP) and β-CTX-I may be elevated in CKD due to renal retention. Bone alkaline phosphatase (BALP), intact PINP (iPINP), and tartrate resistant acid phosphatase 5b (TRACP5b) show the most promise in discriminating high and low turnover bone diseases in patients with advanced CKD and for predicting fracture risk, monitoring treatment response, and assessing the risk of treatment-related complications.

Conclusion: We re-affirm the use of serum/plasma tPINP and plasma β-CTX-I as reference BTMs with appropriate patient preparation and sample handling and measurement by standardized/harmonized assays in clinical studies to accumulate further data, and for monitoring treatment of osteoporosis in the setting of normal renal function in clinical practice. BALP and TRACP5b, measured by standardized assays, are recommended as reference BTMs for CKD-associated osteoporosis and should be included in observational and intervention studies to ascertain their utility for risk-evaluation, treatment initiation, and assessment of treatment response in CKD-associated osteoporosis.

目的:国际骨质疏松症基金会(IOF)和国际临床化学与检验医学联合会(IFCC)建议将I型胶原蛋白的I型N前肽(PINP)和I型胶原蛋白的β异构化C端端肽(β-CTX-I)作为骨质疏松症的参考骨转换标志物(BTMs)。本报告研究了自 2011 年 IOF-IFCC 立场文件发布以来已发表的文献,以确定参考 BTM 和新标记物在预测骨折风险和监测骨质疏松症治疗方面的临床潜力:方法:通过对 Medline 数据库中 2011 年至 2024 年 5 月期间的文献进行回顾,从前瞻性研究中收集有关 BTM 与后续骨折之间关系的证据。此外,还研究了治疗对 BTMs 的影响。此外,还研究了晚期慢性肾脏病患者在评估骨转换时 BTM 的准确性:结果:BTM 浓度升高与绝经后妇女骨折风险升高有关。血液中测量的 PINP 和 β-CTX-I 与骨折风险有关,但它们与其他风险因素的相互作用尚未得到充分研究,这限制了将它们纳入骨折风险算法。治疗引起的 PINP 和 β-CTX-I 的变化在降低骨折风险中占很大比例,有助于提高依从性;建议将它们纳入研究,以检查个体患者的依从性。不过,在慢性肾脏病患者中,总 PINP(tPINP)和 β-CTX-I 可能会因肾脏潴留而升高。骨碱性磷酸酶(BALP)、完整 PINP(iPINP)和酒石酸抗性酸性磷酸酶 5b (TRACP5b)在鉴别晚期 CKD 患者的高周转和低周转骨病、预测骨折风险、监测治疗反应和评估治疗相关并发症的风险方面显示出最大的前景:我们再次重申,在临床研究中使用血清/血浆 tPINP 和血浆 β-CTX-I 作为参考 BTMs,并进行适当的患者准备和样本处理,通过标准化/协调化验方法进行测量,以积累更多数据,并在临床实践中用于监测肾功能正常情况下的骨质疏松症治疗。建议将通过标准化测定法测量的 BALP 和 TRACP5b 作为 CKD 相关性骨质疏松症的参考 BTM,并应将其纳入观察性和干预性研究,以确定它们在 CKD 相关性骨质疏松症的风险评估、治疗启动和治疗反应评估中的效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Osteoporosis International
Osteoporosis International 医学-内分泌学与代谢
CiteScore
8.10
自引率
10.00%
发文量
224
审稿时长
3 months
期刊介绍: An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信