II. Indications (used more as a research tool currently)

  1. Monitor peri-menopausal and postmenopausal bone loss
  2. Monitor treatment outcomes

III. Labs: Bone formation (Serum markers)

  1. Alkaline Phosphatase (total)
  2. Alkaline Phosphatase (skeletal isoenzymes)
  3. Procollagen-I Extension peptide
  4. Osteocalcin

IV. Labs: Bone resorption (most are urine markers)

  1. Urine Calcium
  2. Urine hydroxyproline
  3. Serum type I collagen breakdown product (serum CTX)
  4. Collagen cross-link fragments (first to be hydrolyzed)
    1. Urine Total pyridinoline
    2. Urine Free deoxypyridinoline
    3. Urine N-Telopeptide (n-terminus of collagen fibril)
    4. Urine C-Telopeptide (c-terminus of collagen fibril)

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