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Biochemical markers of bone turnover in patients with metastatic bone disease.

Abstract
Several biochemical markers of bone formation and bone resorption have recently been developed. These markers have been evaluated for clinical utility in patients with metabolic bone disease, including Paget disease and osteoporosis, and for their potential use in cancer patients whose disease has metastasized to bone. We have evaluated seven markers of bone turnover in the plasma and urine of 94 patients with newly diagnosed or progressive malignancy with and without clinical evidence of bone metastases. As determined by a positive bone scan and (or) bone survey, 30 patients had metastases to bone; 51 patients had metastatic cancer without overt bony involvement; and 13 patients had local disease without bone metastases. To evaluate the predictive value of these markers in the metastatic population, we utilized a "Z-score" and logistic regression analysis to distinguish patients with documented bone metastatic disease from those patients without clinical evidence of bone metastases. The higher the Z-score, the better the marker predicts the presence of bone metastases. With this statistical approach, urine N-telopeptide measurements had the highest Z-score and the most significant association with the probability of bone metastases. Urine deoxypyridinoline was the second most predictive marker of bone metastases. Thus, biochemical markers of bone resorption might be of use to predict the presence of bone metastases in cancer patients and to monitor the efficacy of antiresorptive therapy in patients treated for metastatic bone disease.
AuthorsL M Demers, L Costa, V M Chinchilli, L Gaydos, E Curley, A Lipton
JournalClinical chemistry (Clin Chem) Vol. 41 Issue 10 Pg. 1489-94 (Oct 1995) ISSN: 0009-9147 [Print] England
PMID7586522 (Publication Type: Journal Article)
Chemical References
  • Amino Acids
  • Biomarkers
  • Collagen Type I
  • Cross-Linking Reagents
  • PTHLH protein, human
  • Parathyroid Hormone-Related Protein
  • Peptides
  • Proteins
  • collagen type I trimeric cross-linked peptide
  • pyridinoline
  • deoxypyridinoline
  • Collagen
  • Alkaline Phosphatase
Topics
  • Alkaline Phosphatase (blood)
  • Amino Acids (urine)
  • Biomarkers
  • Bone Neoplasms (physiopathology, secondary)
  • Bone Remodeling
  • Collagen (urine)
  • Collagen Type I
  • Cross-Linking Reagents
  • Female
  • Humans
  • Male
  • Parathyroid Hormone-Related Protein
  • Peptides (urine)
  • Proteins (analysis)
  • Regression Analysis

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