Knochenumbaumarker

Zusammenfassung

Knochenumbauparameter können zusätzliche Informationen zur Abschätzung der Dynamik des Knochenstoffwechsels in der Osteoporosediagnostik nebst Knochendichte, den klinischen Daten und Routine-Laborparametern liefern. Zu den Aufbaumarkern des Knochenstoffwechsels zählen Prokollagen Typ 1 N-terminales Propeptid (P1NP), die knochenspezifische alkalische Phosphatase (bALP) und Osteokalzin (OC), zu den Abbaumarkern des Knochenstoffwechsels gehören Pyridinolin (PYD) und Desoxypyridinolin (DPD), N-terminales Kollagen-Typ-I-Telopeptid (NTX) und C-terminales Kollagen-Typ-ITelopeptid (CTX), β-CrossLaps (β-CTX), die Tartrat-resistent saure Phosphatase (TRAP5b) sowie Cathepsin K. Das Einsatzgebiet liegt vor allem in der Verlaufsbeurteilung nach Einleitung einer Osteoporosetherapie und im Compliance-Monitoring. Knochenumbaumarker stellen jedoch derzeit keine alleinige Entscheidungsgrundlage zur Initiierung einer Therapie dar. In der Hämatoonkologie scheinen hohe Knochenabbaumarker mit einem höheren Rezidivrisiko bzw. einem höheren Risiko für skelettassoziierte Ereignisse verbunden zu sein.

Summary

Parameters assessing bone turnover may provide additional information in the diagnosis of osteoporosis, adding to bone mineral density, clinical data and routine laboratory. Parameters of bone formation include procollagen type 1 N-terminal propeptide (P1NP), bone-specific alkaline phosphatase (bALP) and osteocalcin (OC). Parameters of bone resorption are pyridinoline (PYD) and desoxypyridinoline (DPD), N-terminal collagen type I-telopeptide (NTX) and C-terminal collagen type I-telopeptide (CTX), β-crosslaps (β-CTX), tartrate-resistant acid phosphatase (TRAP5b) as well as cathepsin K. The clinical utility lies especially in the monitoring of bone turnover after initiation of osteoporosis therapy to evaluate treatment efficacy and in the monitoring of patient compliance, while the decision to commence treatment cannot be based solely on bone turnover markers alone. In haemato-oncology, high bone turnover markers, especially high parameters of bone resorption, are associated with a higher risk for skeletal-related events.

Schlüsselwörter

P1NP - Osteokalzin - CrossLaps

Keywords

P1NP - osteocalcin - crosslaps

• Literatur

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