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Osteologie 2023; 32(04): 251-258
DOI: 10.1055/a-2189-6143
Review

Biochemische Marker des Knochenstoffwechsels im Blickwinkel knochenrelevanter Erkrankungen

Biochemical Markers of Bone Turnover in the Light of Bone Relevant Diseases
Hans Peter Dimai 
1   Klinische Abteilung für Endokrinologie und Diabetologie, Medizinische Universität Graz, Graz, Austria
,
Barbara Obermayer-Pietsch
2   Universitätsklinik für Innere Medizin und Universitätsklinik für Frauenheilkunde & Geburtshilfe, Medizinische Universität Graz, Graz, Austria
› Author Affiliations Finanzielle Unterstützung Die Verfassung des vorliegenden Manuskriptes wurde unter Verwendung von Mitteln und Infrastruktur der Medizinischen Universität Graz (Graz, Österreich) unterstützt.
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Zusammenfassung

Das knöcherne Skelett unterliegt zeitlebens einem intensiven Umbau, welcher sich unter anderem laborchemisch durch Messung von im Blut zirkulierenden Substraten des Knochenanbaus und Knochenabbaus quantifizieren lässt. Diese Substrate werden in ihrer Gesamtheit häufig unter dem Begriff „Knochenumbauparameter“ oder „biochemische Marker des Knochenumsatzes“ zusammengefasst. Sie können direkt dem Stoffwechsel knochenspezifischer Zellen entstammen, wie etwa die Alkalische Phosphatase (ALP), das Osteocalcin (OC) oder die Tartrat-resistente saure Phosphatase (TRAP), oder im Rahmen des Knochenabbaus aus der organischen Knochenmatrix freigesetzt werden, wie zum Beispiel das C-terminale oder N-terminale Telopeptid des Typ-1 Kollagens (CTX, NTX). Für eine erhebliche Anzahl unterschiedlicher Erkrankungen konnte in den vergangenen Jahren und Jahrzehnten ein Effekt auf den Knochenstoffwechsel, und somit auf die entsprechenden Knochenumbauparameter, nachgewiesen werden. Hierbei stehen Erkrankungen, welche eine Beschleunigung des Knochenumsatzes bewirken jenen gegenüber, welche zu einer Verlangsamung desselben führen. Die Messung von Knochenumbauparametern im Blut und somit die Information über das Ausmaß des Knochenumbaus können unterstützend für therapeutische Maßnahmen herangezogen werden. Die diagnostische Bedeutung oder der diagnostische Mehrwert der Knochenumbauparameter bleiben hierbei allerdings auf einige wenige Ausnahmen beschränkt.

Abstract

Bone is a living tissue characterised by a lifelong turnover process. The latter can be quantified by measurement of specific circulating substrates which reflect either bone formation or bone resorption, and thus are also referred to as biochemical markers of bone turnover, or simply bone turnover markers. They may either be secreted directly by bone cells, such as the alkaline phosphatase (ALP), osteocalcin (OC) and the tartrate-resistant acid phosphatase (TRAP), or released from bone matrix during bone degradation, such as the C-terminal and N-terminal telopeptide of type-1 collagen (CTX, NTX). In the years past, a considerable number of diseases have been identified to affect bone metabolism with the consequence of an increase or decrease of these markers. Accordingly, such diseases can be classified as either associated with high or low bone turnover. Measurement of and information about these circulating markers may support decision making when treatment is considered. However, in general their added-value remains low regarding the diagnosis of such diseases.

Schlüsselwörter

biochemische - Marker - Knochenumsatz - Erkrankungen

Key words

biochemical - markers - bone - turnover


Publication History

Received: 12 August 2023

Accepted: 10 October 2023

Article published online:
04 December 2023

© 2023. Thieme. All rights reserved.

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