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Bone Turnover

A comprehensive panel of markers for bone turnover assessment.

Throughout life, old bone is constantly removed (bone resorption) and replaced by new bone (formation). This continual process, named bone remodelling, is essential for the maintenance of healthy bone mass and structural integrity1.

Bone turnover markers (BTMs) are released during the bone remodelling process and are measurable in blood or urine. Depending on their involvement in the process, BTMs are categorised into:

  • Bone formation markers, such as N-terminal propeptide of type I procollagen (PINP), bone alkaline phosphatase (BAP) and osteocalcin
  • Bone resorption markers including C-terminal telopeptides of type I collagen (CTX-I) and tartrate-resistant-acid phosphatase 5b (TRAcP-5b)

BTMs are increasingly used in routine clinical management of osteoporosis, especially for monitoring therapy, in addition to their use in other metabolic bone disease, such as Paget’s disease of bone and osteomalacia:

  • CTX-I and PINP have been designated as reference BTMs for use in the management of osteoporosis¹⁻³.
  • Concentrations of bone turnover enzymes in blood provide reliable information of bone turnover in patients with impaired kidney function:
    • BAP is recommended for use in the assessment of bone disease in patient with CKD-MBD⁴.
    • TRAcP-5b seems to be the only resorption marker that is not influenced by decline or failure in kidney function or dialysis in patients with CKD⁵.

We provide a comprehensive portfolio of BTM immunoassays, fully automated CLIA and traditional technology, allowing laboratories to fulfil their roles in helping the clinicians to manage and improve patient outcomes.

  1. www.iofbonehealth.org
  2. Vasikaran S et al. Clin Chem Lab Med 2011 Aug; 49(8):1271–1274.
  3. Bauer D et al. Osteoporos Int. 2012 Oct;23(10):2425-33
  4. Ketteler M et al. Ann Intern Med. 2018 Mar 20;168(6):422-430.
  5. Vasikaran S et al. Calcif Tissue Int. 2021 Nov 30

Bone Turnover Products

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Assays Certification Platform Clinical Area Portfolio RUO/IVD
Alpha CrossLaps® (CTX-I) EIA 510 (k) exemptCE Marked Bone TurnoverBone Turnover Markers Animal ResearchEndocrinology IVD
BoneTRAP® (TRAcP 5b) ELISA CE Marked Bone TurnoverBone Turnover Markers Animal ResearchEndocrinology IVD
CTX-I (CrossLaps®) CE MarkedFDA Cleared i10iSYS Bone Turnover Endocrinology IVD
Intact PINP CE Marked i10iSYS Bone TurnoverCKD-MBD Endocrinology IVD
N-MID® Osteocalcin CE Marked i10iSYS Bone Turnover Endocrinology IVD
N-MID® Osteocalcin ELISA CE MarkedFDA Cleared Bone TurnoverBone Turnover Markers Animal ResearchEndocrinology IVD
Ostase® BAP CE MarkedFDA Cleared i10iSYS Bone TurnoverCKD-MBD Endocrinology IVD
Ostase® BAP EIA CE MarkedFDA Cleared Bone TurnoverBone Turnover Markers Animal ResearchEndocrinology IVD

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