Assessment of bone turnover by bone markers: clinical application and significance

Monitoring of bone cell activity, i.e. osteoblasts and osteoclasts, is possible by measurements of bone remodelling products in blood and urine. Substantial scientific evidence indicates that biochemical markers of bone turnover are bone specific and enable insight into the dynamics of bone metabolism. The most comprehensive data are available for the monitoring of osteoporosis treatment effects, for which use clinical guidelines have been defined. Measurement of bone markers in other metabolic bone disorders and malignant diseases with skeletal involvement is important in diagnostic assessment and therapy monitoring. Interpretation of results should take into consideration biological variations of these analytes.