Bone, it’s Architecture, Markers of Resorption and Their Role in Osteoporosis in India: A Detailed Review

Bone is a dynamic tissue that undergoes constant remodeling throughout the life span. Bone turnover is an equilibrium between the rates of bone formation and resorption. Assay of bone turnover markers (BTMs) is very important as they provide an insight in to the dynamics of bone turnover in many metabolic bone disorders. An increase in bone turnover seen with aging and pathological states such as osteoporosis leads to deterioration of bone microarchitecture and thus contributes to an increase in the risk of fracture independent of low bone mineral density (BMD). These microarchitectural alterations affecting the bone quality can be assessed by BTMs and thus may serve as a complementary tool to BMD in the assessment of fracture risk. Osteoporosis is a major health problem in India with 230 million people getting affecting. Women get more crippled as they show an additional accelerated phase of bone loss, which occurs 10 years earlier in India. Bone health in Indian women is more appalling with deficient nutritional status as compared to their counterparts. Biochemical assays are non-invasive, not site specific, reflect the turnover of entire skeleton, can detect early changes in the bone turnover. The present review was aimed to discuss the normal architecture of bone, markers of it’s turnover and their role in osteoporosis in India.