biochemical bone turnover markers and osteoporosis in older men where are we骨代谢生化生化标记和我们在老年男性骨质疏松症.pdfVIP

SAGE-Hindawi Access to Research Journal of Osteoporosis Volume 2011, Article ID 704015, 5 pages doi:10.4061/2011/704015 Review Article Biochemical Bone Turnover Markers and Osteoporosis in Older Men: Where Are We? Pawel Szulc INSERM UMR 1033, Universite de Lyon, Hopital Edouard Herriot, Pavillon F, Place d’Arsonval, 69437 Lyon, France ´ ˆ Correspondence should be addressed to Pawel Szulc, pawel.szulc@inserm.fr Received 29 May 2011; Revised 8 November 2011; Accepted 12 November 2011 Academic Editor: S. Minisola Copyright © 2011 Pawel Szulc. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In men aged less than 60, the association of serum and urinary levels of biochemical bone turnover markers (BTMs) and bone mineral density (BMD) is weak or not significant. After this age, higher BTM levels are correlated weakly, but significantly, with lower BMD and faster bone loss. Limited data from the cohort studies suggest that BTM measurement does not improve the predic- tion of fragility fractures in older men in comparison with age, BMD, history of falls and fragility fractures. Testosterone replace- ment therapy (TRT) decreases bone resorption. During TRT, bone formation markers slightly increase (direct effect on osteo- blasts), then decrease (slowdown of bone turnover). Bisphosphonates (alendronate, risedronate, ibandronate, zoledronate) induce a rapid decrease in bone resorption followed by a milder decrease in bone formation. In men receiving antiresorptive therapy for prostate cancer, zoledronate, denosumab and toremifene decrease significantly levels of bone resorption a