[Bone quality and bone metabolism (marker)]

NIH Consensus Development Panel states that bone strength primarily reflects the integration of bone density and bone quality. In addition, it is reported that bone quality refers to architecture, turnover, damage accumulation, and mineralization. Increased bone turnover is an independent risk of fracture of low bone mineral density. Increased bone turnover of urinary CTX, free DPD and free PYD, or decreased turnover of serum ICTP leads to increased relative risk of fractures in the femoral neck or spine/non-spine. Reduction of 50-70% in bone metabolic markers with therapy reduces fracture risk by 40-44%.