Review of Bone Turn over Biomarkers for Early Diagnose of Osteoporosis

Abstract

Introduction: Osteoporosis is a worldwide major burden among postmenopausal women. Not only the women, men are also prone to osteoporosis and fragility fractures with increasing age. The underlying pathology of osteoporosis is actually an imbalance among bone turnover cells including osteoblasts and osteoclasts. The rate of bone formation and resorption can be either measured by using urinary excretion of different biochemical markers or their presence in serum as well. Objective: The aim of this review article was to collate all the osteoporotic biomarkers, their role in assessing risk of fractures, and monitoring of treatment potency. Methodology: A web-based search was used and online data bases from PUBMED and MEDLINE were searched for osteoporosis. Studies from the year of 2000 up to 2017 were included. A total of 28 studies were included in the review which fulfilled the study parameters. Results: Bone turnover biomarkers are not only helpful in early identification of the osteoporosis and fracture risk but also for the follow-up purpose after the antiresorptive treatment. These are also helpful in identifying over suppression of bone turn over after taking long term treatment of osteoporosis so beneficial in monitoring of patient taking long term treatment or who are on treatment holiday. The including biomarkers are bone-specific alkaline phosphatase, Procollagen type 1 amino-terminal propeptide, Osteocalcin, Procollagen type 1 carboxy-terminal propeptide, receptor activator of nuclear factor NF-κB ligand, Osteoprotegerin, Carboxy-terminal telopeptide cross-linked type 1 collagen, type 1 collagen amino-terminal telopeptide, deoxypyridinoline, tartrate-resistant acid phosphatase, Cathepsin K and hydroxylysine. Conclusion: At the end of this mini-review, it can be concluded that the bone biomarkers have enough potential to act as an indicator in early prediction of the risk of osteoporosis and fracture along with the follow up after osteoporosis therapy. Multiple studies are going on to introduce novel biomarkers using genomic and proteomic approaches.