Clinical assessment of bone status

Bone mass can now be measured very precisely by physical methods such as DEXA (dual energy X-ray absorptiometry), and turnover itself can be assessed using biochemical markers of bone resorption and formation.

Monitoring of bone metabolism by biochemical means depends upon measurement of enzymes and proteins released during bone formation (such as alkaline phosphatase, osteocalcin and collagen propeptides), and of degradation products produced during bone resorption. The most useful markers of bone resorption are degradation products derived from the enzymatic hydrolysis of type I collagen, particularly peptides related to regions of cross-linking with the pyridinolines.

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