Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards: osteoporos int 2011;22:391-420

ArticleinThe Clinical biochemist. Reviews / Australian Association of Clinical Biochemists 32(1):45-7 · February 2011with8 Reads
Source: PubMed
  • [Show abstract] [Hide abstract] ABSTRACT: Thesis (Ph. D.)--Stanford University, 1997. Submitted to the School of Education. Copyright by the author.
    Article · · Osteoporosis International
  • [Show abstract] [Hide abstract] ABSTRACT: Low bone mineral density (BMD) is a strong risk factor for low trauma fractures in the postmenopausal population without known chronic kidney disease (CKD). In stage 1–3 CKD, low BMD can also be used to predict fracture risk with the gradient of risk similar to patients without CKD even though patients with stage 3 CKD have an approximate doubling of risk compared with age-matched patients without CKD. This greater risk of fracture in stage 3 CKD is not calculated in the current FRAX model. In stage 4–5 CKD, BMD by dual-energy x-ray absorptiometry (DXA) is a poor predictor of fracture risk probably related to the severe derangements in bone metabolism in severe CKD, which alter bone quality and strength not measured by DXA. Serial BMD by DXA, however, may be useful in all stages of CKD to monitor for potential loss of BMD or effect of pharmacological agents to improve BMD. Newer radiological technologies, particularly high-resolution peripheral quantitative computerized tomography (HRpQcT) of the radius and tibia show promise to define the microstructural changes in bone that explain the greater risk of fracture observed in patients with CKD versus patients without CKD. BMD by DXA may still be of value across the spectrum of CKD, but physicians should realize its limitations and understand the greater risk of fracture in patients in all stages of CKD as compared to age-matched and BMD-matched patients without CKD.
    Article · Sep 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Guidance is provided in a European setting on the assessment and treatment of postmenopausal women with or at risk from osteoporosis. The European Foundation for Osteoporosis and Bone disease (subsequently the International Osteoporosis Foundation) published guidelines for the diagnosis and management of osteoporosis in 1997. This manuscript updates these in a European setting. The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case finding strategies; investigation of patients; health economics of treatment. A platform is provided on which specific guidelines can be developed for national use.
    Full-text · Article · May 2008
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