Molecular Basis and Clinical Application of Biological Markers of Bone Turnover*

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Abstract
I. Introduction THERE is increasing awareness among scientists, clinicians, policy makers, and the general public of the costs and health care problems associated with osteoporosis, the most common metabolic bone disease. If the disease could be prevented or effectively treated, then deaths, disabilities, and costs due to osteoporosis would be substantially reduced. To this end, considerable emphasis has been placed on developing and improving indicators of bone remodeling for 1) identifying people at risk, 2) early diagnosis, and 3) determining effective therapy for those with established disease. Although the clinician's ability to diagnose and monitor bone disease has improved in the past decade, there is still a need for more specific methods of assessing disturbances in bone metabolism. Bone status can be assessed by dynamic histomorphometry of a biopsy specimen, but the technique is invasive, and results from a single core biopsy may not apply to other sites in the skeleton.

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