What labs are used to assess bone turnover in osteopenia?

From the Research

Bone Turnover Markers

The following bone turnover markers are used to assess bone turnover in osteopenia:

• Bone formation markers:
  • Bone alkaline phosphatase
  • Osteocalcin
  • Procollagen I N-propeptide (PINP) 1, 2, 3
• Bone resorption markers:
  • Serum C-telopeptides of type I collagen (CTX-I) 1, 2
  • Urinary N-telopeptides of type I collagen
  • Tartrate-resistant acid phosphatase type 5b (TRAP 5b) 1, 3
  • β-form of C-terminal cross-linked telopeptide of type I collagen (β-CTx-1/β-CrossLaps) 3

Laboratory Tests

These markers are usually measured by:

• Enzyme-linked immunosorbent assay (ELISA) 1
• Automated immunoassay 1

Variability and Interpretation

Sources contributing to variability in bone turnover markers include:

• Uncontrollable factors: age, gender, ethnicity 1, 2
• Controllable factors: collection conditions (e.g., fasting/feeding state, timing relative to circadian rhythms, menstrual cycling, and exercise) 1, 2
• Other factors: pregnancy, season, drugs, and recent fracture(s) 1, 2 It is essential to consider these factors when interpreting bone turnover marker measurements 1, 2, 3