Predicting bone loss and fracture risk with biochemical markers: A review.

Numerous studies have reported associations of biochemical markers of bone turnover with rates of change in bone density. Increasing levels of both formation and resorption markers are associated with faster rates of decline in bone mineral density. The differences in bone loss rates among persons predicted from marker levels correspond to clinically significant differences in fracture risk. Markers have also been shown to predict fracture risk directly, although increases in certain markers are associated with increased risk in some studies, and other markers with decreased risk in other studies. The associations of biochemical markers with fracture risk are similar in magnitude to those for bone density and fractures. Taken together, existing data provide convincing evidence that biochemical markers can help determine which women are at increased risk of rapid bone loss and fracture.