Evidence map›Paper›PMID 21184054›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2011

Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards.

S Vasikaran, R Eastell, O Bruyère, A J Foldes, P Garnero, A Griesmacher, M McClung, H A Morris, S Silverman, T Trenti and 4 more

3 registry-linked trialsAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 525 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
525citing papers in PubMed, 14 pooled it
29.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03371199 nacompletednot on this mapstarted 2017, after this paper: background citation

The Effect of Normalization of Sodium on Bone Markers in Patients With Epilepsy. A Randomized Single-blinded Placebo-controlled Trial.

TypeinterventionalSponsorRigshospitalet, DenmarkRan2017 to 2018Enrolled21ConditionsHyponatremia, Metabolic Bone DiseaseArmsSodium chloride, Placebo Oral Tablet
NCT07094568 recruitingnot on this mapstarted 2025, after this paper: background citation

Comparative Investigation of Changes in Body Composition and Bone Turnover Markers in People With Obesity After Treatment With Tirzepatide Versus Liraglutide. A Prospective Cohort Study.

TypeobservationalSponsorNational and Kapodistrian University of AthensRan2025 to 2026Enrolled72ConditionsObesity (Disorder)
NCT07473713 phase1recruitingnot on this mapstarted 2026, after this paper: background citation

Veverimer to Decrease Net Acid Excretion and Bone Resorption in Adults With Osteopenia: a Dose-finding Randomized Controlled Trial

TypeinterventionalSponsorTufts Medical CenterRan2026 to 2028Enrolled60ConditionsOsteopeniaArmsveverimer daily, veverimer every other day, Placebo
3 · Its place in the literature

Who cites it

525 citing papers in PubMed, 14 syntheses or guidelines pooled it, 1,149 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Guideline
  10. Pooled it
  11. Pooled it
  12. Effect of SGLT2 inhibitors on fractures, BMD, and bone metabolism markers in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Pooled it
  13. Pooled it
  14. Pooled it
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

465 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 7 countries.

S VasikaranDepartment of Core Clinical Pathology and Biochemistry, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA, Australia.
R Eastell
O Bruyère
A J Foldes
P Garnero
A Griesmacher
M McClung
H A Morris
S Silverman
T Trenti
D A Wahl
C Cooper
J A Kanis
IOF-IFCC Bone Marker Standards Working Group
Cedars-Sinai Medical Center · USInserm · FRSouthampton General Hospital · GBUniversity of Liège · BEBone Health and Osteoporosis Foundation · USRoyal Perth Hospital · AUThe University of Western Australia · AUUniversity of Sheffield · GBUniversity of South Australia · AU

Funding

Medical Research Council MC_UP_A620_1014
6 · The paper itself

Abstract

unlabelledThe International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommend that a marker of bone formation (serum procollagen type I N propeptide, s-PINP) and a marker of bone resorption (serum C-terminal telopeptide of type I collagen, s-CTX) are used as reference analytes for bone turnover markers in clinical studies.

introductionBone turnover markers (BTM) predict fracture risk, and treatment-induced changes in specific markers account for a substantial proportion of fracture risk reduction. The aims of this report were to determine their clinical potential in the prediction of fracture risk and for monitoring the treatment of osteoporosis and to set an appropriate research agenda.

methodsEvidence from prospective studies was gathered through literature review of the PUBMED database between the years 2000 and 2010 and the systematic review of the Agency for Healthcare Research and Quality up to 2001.

resultsHigh levels of BTMs may predict fracture risk independently from bone mineral density in postmenopausal women. They have been used for this purpose in clinical practice for many years, but there is still a need for stronger evidence on which to base practice. BTMs provide pharmacodynamic information on the response to osteoporosis treatment, and as a result, they are widely used for monitoring treatment in the individual. However, their clinical value for monitoring is limited by inadequate appreciation of the sources of variability, by limited data for comparison of treatments using the same BTM and by inadequate quality control. IOF/IFCC recommend one bone formation marker (s-PINP) and one bone resorption marker (s-CTX) to be used as reference markers and measured by standardised assays in observational and intervention studies in order to compare the performance of alternatives and to enlarge the international experience of the application of markers to clinical medicine.

conclusionBTM hold promise in fracture risk prediction and for monitoring treatment. Uncertainties over their clinical use can be in part resolved by adopting international reference standards.

Indexed as

AdultAgedAged, 80 and overAlgorithmsBiomarkersBone DensityBone RemodelingFemaleHumansMaleMiddle AgedOsteoporosisOsteoporosis, PostmenopausalOsteoporotic FracturesReference StandardsRisk AssessmentBiomarkers

Identifiers

PMID21184054
OpenAlexW2005779589

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.