Osteoporosis laboratory findings: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(33 intermediate revisions by 6 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Osteoporosis}}
{{Osteoporosis}}
{{CMG}}; {{AE}}{{CZ}}, [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]][mailto:ravitheja.g@gmail.com]
{{CMG}}; {{AE}}{{EG}}


==Overview==
==Overview==
Lab tests for the diagnosis of [[osteoporosis]] include some baseline tests like [[complete blood count]] (CBC), [[serum calcium]], [[phosphate]], [[alkaline phosphatase]], and 25(OH) vitamin D. There are also tests for diagnosing secondary osteoporosis, which include 24 hr serum calcium, serum [[protein electrophoresis]] and [[bone marrow biopsy]].
There is a limited role for [[Laboratory techniques|laboratory tests]] in the diagnosis of osteoporosis; however, they may be used for differentiating primary versus secondary causes of the [[disease]]. [[Laboratory techniques|Laboratory tests]] for the [[diagnosis]] of osteoporosis include some baseline tests like [[Complete blood count|complete blood count (CBC)]], [[Calcium|serum calcium]], [[phosphate]], [[alkaline phosphatase]], and [[Vitamin D|25-(OH)-vitamin D]]. There are tests for diagnosing secondary osteoporosis, which include but not limited to 24 hr [[Calcium|serum calcium]], serum [[protein electrophoresis]], and serum [[Thyroid hormone|thyroid hormones]].


==Laboratory findings==
==Laboratory findings==
There is a limited role for laboratory tests in diagnosis of osteoporosis; however, they may be used for differentiating primary versus secondary causes of the disease.  
There is a limited role for [[Laboratory techniques|laboratory tests]] in the diagnosis of [[osteoporosis]]; however, they may be used for differentiating primary versus secondary causes of the disease.  


===Electrolyte and Bio-marker Studies===
=== Electrolyte and Biomarker Studies ===
<br><span style="font-size:85%">Abbreviations:</span>


==== [[Complete blood count|Complete blood count (CBC)]] ====
<span style="font-size:85%">HGB: Hemoglobin</span>
* Reduced hemoglobin level may reveal [[sickle cell anemia]], [[multiple myeloma]], or [[alcoholism]] associated osteoporosis
* Elevated WBC count may reveal leukemia/lymphoma associated osteoporosis
* Reduced number of all cell types (RBC, WBC, and platelet) may reveal aplasia associated osteoporosis


==== Serum [[calcium]] level and/or 24-hr serum calcium ====
<span style="font-size:85%">WBC: White blood cell</span>
* Severe [[hypercalcemia]] may reflect [[malignancy]] or [[hyperparathyroidism]] associated osteoporosis
* [[hypocalcemia]] may reflect vitamin D deficiency or hypoparathyroidism associated [[osteoporosis]]


==== Serum [[phosphate]] level ====
<span style="font-size:85%">RBC: Red blood cell</span>
* Reduced serum [[phosphate]] level may reveal '''hypophosphatemic rickets''' or nephrolithiasis osteoporosis type 1 (NPHLOP1) associated osteoporosis
* Elevated serum [[phosphate]] level may reveal vitamin D deficiency, chronic kidney disease, or hypoparathyroidism associated osteoporosis


==== Serum [[alkaline phosphatase]] level ====
<span style="font-size:85%">IgM: Immunoglobulin M type</span><blockquote></blockquote>
* Elevated serum [[alkaline phosphatase]] level may reveal postmenopausal or destructive bone diseases (e.g., bone tumor) associated osteoporosis
{| style="text-align: center;" cellpadding="2" border="1"
|- style="background:LightGrey"
! rowspan="2" |Disease
! colspan="18" |Electrolyte and Bio-marker Studies
|- style="background:LightGrey"
| [[Complete blood count|Complete blood count (CBC)]]
| Serum [[calcium]] level
| 24-hr serum [[calcium]]
| Serum [[phosphate]] level
| Serum [[alkaline phosphatase]] level
| Serum [[Vitamin D|25-(OH)-vitamin D]] level
| Serum [[magnesium]] level
| Serum [[creatinine]] level
| Serum [[iron]] and [[ferritin]] level
| [[Liver function tests]]
| [[Thyroid function tests]]
| Serum [[Parathyroid hormone|parathyroid hormone (PTH)]] level
| Serum [[Testosterone]]/[[gonadotropin]] level
| Urine free [[cortisol]] level
| [[Dexamethasone suppression test|Over night dexamethasone suppression test]]
| [[Serum protein electrophoresis]]/ Urine [[protein electrophoresis]]
| [[Anti-gliadin antibodies|Anti-gliadin]] <br> Anti-endomysial antibodies
| Serum [[tryptase]] <br> Urine N-methylhistamine
|-
| [[Postmenopausal osteoporosis]]
| -
| -
| -
| -
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Vitamin D deficiency]]
| -
| ↓
| ↓
| ↓
| ↑
| ↓
| ↓
| -
| -
| -
| -
| ↓
| -
| -
| -
| -
| -
| -
|-
| [[Sickle cell anemia]]
| ↓[[Hemoglobin|HGB]]
| -
| -
| -
| ↑
| -
| -
| -
| ↓
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Multiple myeloma]]
| ↓[[Hemoglobin|HGB]]
| ↑
| ↑
| ↑
| ↑
| -
| -
| ↑
| ↓
| -
| -
| -
| -
| -
| -
| ↑ [[IgM]]
| -
| -
|-
| [[Leukemia]]/[[lymphoma]]
| ↑[[WBC]]
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Alcoholism]]
| ↓[[Hemoglobin|HGB]]
| -
| -
| -
| -
| -
| -
| -
| ↓
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
|-
| [[Aplasia]]
| ↓[[Red blood cell|RBC]], ↓[[WBC]], ↓[[Platelet|PLT]]
| -
| -
| -
| -
| -
| -
| -
| ↓
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Malignancy]]
| -
| ↑↑↑
| ↑↑↑
| ↑
| ↑
| -
| -
| ↑
| -
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
|-
| [[Hypophosphatemic rickets]]
| -
| ↓↓
| ↓
| ↓
| ↑
| ↓↓
| ↓
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Chronic kidney disease]]
| ↓[[Hemoglobin|HGB]]
| ↑↑
| ↑↑
| ↓↓
| -
| ↓
| ↑
| ↑↑↑
| ↓
| -
| -
| -
| -
| -
| -
| ↑ Urine protein
| -
| -
|-
| Destructive [[bone]] [[diseases]] (e.g., [[bone tumors]])
| -
| ↑↑
| ↑↑
| ↑
| ↑↑↑
| -
| -
| ↓
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Liver diseases]]
| ↓[[Hemoglobin|HGB]]
| -
| -
| -
| -
| -
| -
| -
| -
| ↑↑
| -
| -
| -
| -
| -
| -
| -
| -
|-
| [[Hemochromatosis]]
| ↑[[Hematocrit|HCT]]
| -
| -
| -
| -
| -
| -
| ↑
| ↑↑↑
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Hyperthyroidism]]
| -
| -
| ↑
| ↑
| -
| -
| -
| -
| -
| -
| ↑↑
| -
| -
| -
| -
| -
| -
| -
|-
| [[Hypoparathyroidism]]
| -
| ↓
| ↓
| ↑
| ↓
| -
| ↓
| -
| -
| -
| -
| ↓↓
| -
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Hyperparathyroidism]]
| -
| ↑
| ↑
| ↓
| ↑
| -
| ↑
| -
| -
| -
| -
| ↑↑
| -
| -
| -
| -
| -
| -
|-
| [[Hypogonadism]]
| ↓[[Hemoglobin|HGB]]
| -
| ↓
| ↓
| -
| -
| -
| -
| -
| -
| -
| -
| ↓↓
| -
| -
| -
| -
| -
|- style="background:#efefef;"
| [[Cushing's syndrome|Hypercortisolism (Cushing's syndrome)]]
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| -
| ↑↑
| not suppresed
| -
| -
| -
|-
| [[Celiac disease]]
| ↓[[Hemoglobin|HGB]]
| ↓
| ↓
| ↓
| ↑
| ↓
| ↓
| ↓
| ↓↓
| -
| ↓
| -
| -
| -
| -
| ↓ Plasma protein
| Positive
| -
|- style="background:#efefef;"
| [[Mastocytosis]]
| ↑[[WBC]]
| ↑
| ↑
| ↑
| -
| -
| -
| ↑
| -
| -
| -
| -
| -
| -
| -
| -
| -
|  Positive
|}</small></small> 


==== Serum 25-(OH)-[[vitamin D]] level ====
===Bone turnover markers===
* Reduced serum 25-(OH)-[[vitamin D]] level may reveal vitamin D deficiency associated osteoporosis
When [[Bone mineral density|bone mineral density (BMD)]] measurements do not provide a clear answer, [[bone turnover]] markers can be used in selected cases to assess the [[fracture]] risk. The combined use of [[Bone mineral density|BMD]] measurements and [[bone]] markers is likely to improve the assessment. [[Bone]] turnover markers are not routinely employed in diagnosing [[osteoporosis]]. [[Bone]] markers have two different types:
 
==== Serum creatinine level ====
* Reduced serum creatinine level may reflect [[chronic renal failure]], which leads to [[renal osteodystrophy]]
 
==== Serum [[magnesium]] level ====
* Reduced magnesium level may reflect vitamin D deficiency associated osteoporosis <ref name="pmid23912329">{{cite journal| author=Castiglioni S, Cazzaniga A, Albisetti W, Maier JA| title=Magnesium and osteoporosis: current state of knowledge and future research directions. | journal=Nutrients | year= 2013 | volume= 5 | issue= 8 | pages= 3022-33 | pmid=23912329 | doi=10.3390/nu5083022 | pmc=3775240 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23912329  }}</ref>
 
==== Serum iron and ferritin levels ====
* Elevated iron and ferritin serum levels may reveal [[hemochromatosis]] associated osteoporosis
[[Liver function tests]] ([[alanine aminotransferase]], [[aspartate aminotransferase]], [[gamma-glutamyl transferase]], and [[bilirubin]])
* Elevated level of liver function tests may reflect liver diseases (e.g., alcoholism) associated osteoporosis
 
==== [[Thyroid function tests]] ====
* Reduced thyroid stimulating hormone (TSH) and elevated free thyroxin (T4) may reveal hyperthyroidism associated osteoporosis
 
==== Serum [[parathyroid hormone]] (PTH) level ====
* Elevated Serum [[parathyroid hormone]] (PTH) level may reflect hyperparathyroidism associated osteoporosis
 
==== Testosterone and gonadotropin levels ====
* Reduced testosterone and gonadotropin levels in men may reveal hypogonadism associated osteoporosis
 
==== Urine free cortisol level ====
* Elevated Urine free cortisol level may reflect hypercortisolism (Cushing's disease) associated osteoporosis
 
==== Other bio-markers tests ====
* Over night dexamethasone suppression test (for identifying [[cushing's syndrome]] associated osteoporosis)
* [[Serum protein electrophoresis]] (SPEP) and urine protein electrophoresis (for identifying [[multiple myeloma]] associated osteoporosis)
* Anti-gliadin and anti-endomysial antibodies (for identifying [[celiac disease]] associated osteoporosis)
* Serum tryptase and urine N-methylhistamine (for identifying [[mastocytosis]] associated osteoporosis)
 
=== Bone turnover markers ===
When [[bone mineral density]] ([[BMD]]) measurements do not provide a clear answer, bone turnover markers can be used in selected cases to assess the fracture risk. The combined use of BMD measurements and bone markers is likely to improve the assessment. Bone markers have two different types:  
* Bone formation markers
* Bone formation markers
** Serum bone–specific alkaline phosphatase; 30 percent reduction may reflect treatment efficacy, increasing bone mineral density (BMD) and decreasing fracture risk<ref name="pmid15231011">{{cite journal |vauthors=Bauer DC, Black DM, Garnero P, Hochberg M, Ott S, Orloff J, Thompson DE, Ewing SK, Delmas PD |title=Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial |journal=J. Bone Miner. Res. |volume=19 |issue=8 |pages=1250–8 |year=2004 |pmid=15231011 |doi=10.1359/JBMR.040512 |url=}}</ref>
** Serum type 1 procollagen; 30 percent reduction may reflect treatment efficacy, increasing BMD and decreasing fracture risk<ref name="pmid152310112">{{cite journal |vauthors=Bauer DC, Black DM, Garnero P, Hochberg M, Ott S, Orloff J, Thompson DE, Ewing SK, Delmas PD |title=Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial |journal=J. Bone Miner. Res. |volume=19 |issue=8 |pages=1250–8 |year=2004 |pmid=15231011 |doi=10.1359/JBMR.040512 |url=}}</ref>
** Serum [[osteocalcin]]; elevated serum osteocalcin level in postmenopausal women reveal primary osteoporosis, also lower BMD in femoral neck and lumbar vertebrae<ref name="pmid26436008">{{cite journal| author=Singh S, Kumar D, Lal AK| title=Serum Osteocalcin as a Diagnostic Biomarker for Primary Osteoporosis in Women. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 8 | pages= RC04-7 | pmid=26436008 | doi=10.7860/JCDR/2015/14857.6318 | pmc=4576601 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26436008  }}</ref>


* Bone resorption markers
* Bone resorption markers
** Urinary [[hydroxyproline]]
{| cellpadding="2" border="1" align="center"
** Urinary total pyridinoline (PYD)
! style="background:#efefef;" |Group
** Urinary free deoxypyridinoline (DPD)
! style="background:#efefef;" |Test
** ●In the Epidemiology of Osteoporosis (EPIDOS) study, older women with urinary C-terminal telopeptide of type 1 collagen (CTX) or free deoxypyridinoline (DPD) excretion above the normal limits for young women had twice the risk of hip fracture as compared with other women (figure 2) [24].
! style="background:#efefef;" |Result
** Tartrate-resistant acid phosphatase 5b
! style="background:#efefef;" |Outcome
** ●In a subset of 682 men participating in the Osteoporotic Fractures in Men (MrOS) study, higher baseline levels of bone turnover (N-terminal propeptide of type 1 procollagen [P1NP], beta C-terminal telopeptide of type 1 collagen [betaCTX], and tartrate-resistant acid phosphatase 5b [TRACP5b]) were associated with greater hip bone loss over five years of follow-up [22].
|-
** [[Bone sialoprotein]] (BSP)
| rowspan="3" |'''Bone formation markers'''
** Urinary collagen type 1 cross-linked N-telopeptide (NTX)
| Serum [[osteocalcin]]<ref name="pmid26436008" />
** For urinary excretion of NTX, an approximately 50 percent decline is predictive of improvement in bone mineral density (BMD) and fracture risk
| Elevated
** ●In the control arm of a trial of 236 postmenopausal women randomly assigned to postmenopausal hormone therapy and calcium versus calcium alone (control), women with the highest quartile value of N-telopeptide of type 1 collagen (NTX) throughout the study had the greatest bone loss compared with women with the lowest quartile value [17].
|
** Serum collagen type 1 cross-linked C-telopeptide (CTX)
* [[Postmenopausal]] [[osteoporosis]]
** serum CTX, P1NP, and BALP, a 30 percent decline is similarly predictive
|-
[[Bone turnover markers]] are not routinely employed in diagnosing osteoporosis.
| Serum bone–specific [[alkaline phosphatase]]<ref name="pmid15231011" />
 
| 30 percent reduction
[[Bone marrow biopsy]] - for hematological disorders
|
 
* Treatment efficacy
* Increasing [[Bone mineral density|bone mineral density (BMD)]]
* Decreasing [[fracture]] risk
|-
| Serum type 1 [[procollagen]]<ref name="pmid15231011" />
| 30 percent reduction
|
* Treatment efficacy
* Increasing [[Bone mineral density|bone mineral density (BMD)]]
* Decreasing [[fracture]] risk
|-
| rowspan="7" |'''Bone resorption markers'''
| Urinary [[hydroxyproline]]<ref name="pmid2099937" />
| Elevated
|
* [[Postmenopausal]] [[osteoporosis]]
|-
| Urinary total pyridinoline (PYD)<ref name="pmid1887826" />
| Elevated
|
* [[Postmenopausal]] [[osteoporosis]]
* Higher [[hip]] [[fracture]] risk
|-
| Urinary free deoxypyridinoline (DPD)<ref name="pmid8889854" />
| Elevated
|
* Higher bone resorption in [[postmenopausal]] female
* [[Lumbar spine]] [[osteoporosis]]
|-
| [[Tartrate resistant acid phosphatase|Tartrate-resistant acid phosphatase 5b]]<ref name="pmid19453262" />
| Elevated
|
* More severe [[osteoporosis]] in [[hip]]
|-
| [[Bone sialoprotein|Bone sialoprotein (BSP)]]<ref name="pmid11763409" />
| Reduced after antiresorptive medicine
|
* Decrease in [[bone]] mass loss  
* Improving [[lumbar vertebrae]] [[Bone mineral density|BMD]]
|-
| Urinary [[collagen]] type 1 cross-linked N-telopeptide (NTX)<ref name="pmid12817758" />
| Reduced to half 
|
* Increase in [[Bone mineral density|BMD]]
* Decrease in [[fracture]] risk
|-
| Serum [[collagen]] type 1 cross-linked C-telopeptide (CTX)<ref name="pmid15231011" />
| 30 percent reduction
|
* Treatment efficacy
* Increasing [[Bone mineral density|bone mineral density (BMD)]]  
* Decreasing [[fracture]] risk
|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
Line 88: Line 522:
{{WH}}
{{WH}}


​​
[[Category:Medicine]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Radiology]]
[[Category:Up-To-Date]]
[[Category:Orthopedics]]
[[Category:Primary care]]

Latest revision as of 23:28, 29 July 2020

Osteoporosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Osteoporosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Life Style Modification
Pharmacotherapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Osteoporosis laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Osteoporosis laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Osteoporosis laboratory findings

CDC on Osteoporosis laboratory findings

Osteoporosis laboratory findings in the news

Blogs on Osteoporosis laboratory findings

Directions to Hospitals Treating Osteoporosis

Risk calculators and risk factors for Osteoporosis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

There is a limited role for laboratory tests in the diagnosis of osteoporosis; however, they may be used for differentiating primary versus secondary causes of the disease. Laboratory tests for the diagnosis of osteoporosis include some baseline tests like complete blood count (CBC), serum calcium, phosphate, alkaline phosphatase, and 25-(OH)-vitamin D. There are tests for diagnosing secondary osteoporosis, which include but not limited to 24 hr serum calcium, serum protein electrophoresis, and serum thyroid hormones.

Laboratory findings

There is a limited role for laboratory tests in the diagnosis of osteoporosis; however, they may be used for differentiating primary versus secondary causes of the disease.

Electrolyte and Biomarker Studies


Abbreviations:

HGB: Hemoglobin

WBC: White blood cell

RBC: Red blood cell

IgM: Immunoglobulin M type

Disease Electrolyte and Bio-marker Studies
Complete blood count (CBC) Serum calcium level 24-hr serum calcium Serum phosphate level Serum alkaline phosphatase level Serum 25-(OH)-vitamin D level Serum magnesium level Serum creatinine level Serum iron and ferritin level Liver function tests Thyroid function tests Serum parathyroid hormone (PTH) level Serum Testosterone/gonadotropin level Urine free cortisol level Over night dexamethasone suppression test Serum protein electrophoresis/ Urine protein electrophoresis Anti-gliadin
Anti-endomysial antibodies 		Serum tryptase
Urine N-methylhistamine
Postmenopausal osteoporosis - - - - ↑ - - - - - - - - - - - - -
Vitamin D deficiency - ↓ ↓ ↓ ↑ ↓ ↓ - - - - ↓ - - - - - -
Sickle cell anemia ↓HGB - - - ↑ - - - ↓ ↑ - - - - - - - -
Multiple myeloma ↓HGB ↑ ↑ ↑ ↑ - - ↑ ↓ - - - - - - ↑ IgM - -
Leukemia/lymphoma ↑WBC ↑ - - - - - - - - - - - - - - - -
Alcoholism ↓HGB - - - - - - - ↓ ↑ - - - - - - - -
Aplasia ↓RBC, ↓WBC, ↓PLT - - - - - - - ↓ ↑ - - - - - - - -
Malignancy - ↑↑↑ ↑↑↑ ↑ ↑ - - ↑ - ↑ - - - - - - - -
Hypophosphatemic rickets - ↓↓ ↓ ↓ ↑ ↓↓ ↓ - - - - - - - - - - -
Chronic kidney disease ↓HGB ↑↑ ↑↑ ↓↓ - ↓ ↑ ↑↑↑ ↓ - - - - - - ↑ Urine protein - -
Destructive bone diseases (e.g., bone tumors) - ↑↑ ↑↑ ↑ ↑↑↑ - - ↓ - - - - - - - - - -
Liver diseases ↓HGB - - - - - - - - ↑↑ - - - - - - - -
Hemochromatosis ↑HCT - - - - - - ↑ ↑↑↑ ↑ - - - - - - - -
Hyperthyroidism - - ↑ ↑ - - - - - - ↑↑ - - - - - - -
Hypoparathyroidism - ↓ ↓ ↑ ↓ - ↓ - - - - ↓↓ - - - - - -
Hyperparathyroidism - ↑ ↑ ↓ ↑ - ↑ - - - - ↑↑ - - - - - -
Hypogonadism ↓HGB - ↓ ↓ - - - - - - - - ↓↓ - - - - -
Hypercortisolism (Cushing's syndrome) - - - - - - - - - - - - - ↑↑ not suppresed - - -
Celiac disease ↓HGB ↓ ↓ ↓ ↑ ↓ ↓ ↓ ↓↓ - ↓ - - - - ↓ Plasma protein Positive -
Mastocytosis ↑WBC ↑ ↑ ↑ - - - ↑ - - - - - - - - - Positive

Bone turnover markers

When bone mineral density (BMD) measurements do not provide a clear answer, bone turnover markers can be used in selected cases to assess the fracture risk. The combined use of BMD measurements and bone markers is likely to improve the assessment. Bone turnover markers are not routinely employed in diagnosing osteoporosis. Bone markers have two different types:

  • Bone formation markers
  • Bone resorption markers
Group Test Result Outcome
Bone formation markers Serum osteocalcin[1] Elevated
Serum bone–specific alkaline phosphatase[2] 30 percent reduction
Serum type 1 procollagen[2] 30 percent reduction
Bone resorption markers Urinary hydroxyproline[3] Elevated
Urinary total pyridinoline (PYD)[4] Elevated
Urinary free deoxypyridinoline (DPD)[5] Elevated
Tartrate-resistant acid phosphatase 5b[6] Elevated
Bone sialoprotein (BSP)[7] Reduced after antiresorptive medicine
Urinary collagen type 1 cross-linked N-telopeptide (NTX)[8] Reduced to half
Serum collagen type 1 cross-linked C-telopeptide (CTX)[2] 30 percent reduction

References

  1. ↑
  2. ↑ 2.0 2.1 2.2
  3. ↑
  4. ↑
  5. ↑
  6. ↑
  7. ↑
  8. ↑

Template:WS Template:WH

​​

Retrieved from "https://www.wikidoc.org/index.php?title=Osteoporosis_laboratory_findings&oldid=1641538"