Bone Health Panel

Osteoporosis is responsible for 1.2 million bone fractures in the U.S. each year. The most common fractures are of the vertebrae, distal radius, and hip. The underlying cause of fractures in osteoporosis is bone fragility, due to a reduction in bone density. We reach our peak bone mineral density (BMD) as young adults. After age 40, BMD declines by 0.5-1% per year. After menopause, there is an additional 2-3% loss per year1. Because inadequate peak BMD in early adulthood is a major contributor to the later development of osteoporosis, prevention through optimal nutrition is essential. Key nutrients that promote bone synthesis include calcium, vitamin C, vitamin D, and vitamin K. The MVL Bone Health Panel includes assessments of two of these key nutrients in plasma, and a simple urine test to measure the rate of bone loss.

The Bone Health Panel consists of:

Vitamin D

Recent cutting-edge reviews by experts in the U.S.2 and Europe3 emphasize the importance of Vitamin D for bone health, immunomodulation, and regulation of cell growth. Vitamin D deficiency and insufficiency are major unrecognized health problems, especially at higher latitudes. A recent study of the nutritional status of women with osteoporosis found that 39% had vitamin D insufficiency (<15 ng/ml in plasma)4. 25(OH)Vitamin D plasma levels of >20 ng/ml are required to maintain calcium homeostasis, and concentrations of >30 ng/ml may be needed for maximum bone and overall cellular health.

Vitamin K

In addition to its role in the synthesis of blood coagulation factors, Vitamin K is also a cofactor in the synthesis of osteocalcin, a key protein in bone formation. Vitamin K may also impact bone metabolism by its influence on urinary calcium excretion, and by inhibiting bone resorption. Research studies demonstrate that low Vitamin K intake is associated with an increased rate of hip fractures, and that adequate intakes of both Vitamin D and Vitamin K are necessary to achieve a reduction in hip fractures5. Inadequate Vitamin K intake appears to be especially common among American teenagers and young adults6.

NTx

The Osteomark NTx assay is a direct measure of bone resorption. If possible, a patient should have a baseline NTx test before menopause, and then follow-up testing during menopause to determine her rate of bone loss. The NTx test can be especially helpful when weighing the risks and benefits of hormone replacement therapy. It can be used in conjunction with BMD tests to track a patient’s bone health and response to therapy7.References:

1 Olson RE. Am J Clin Nutr. 2000 May;71(5):1031-2.
2 Holick MF. J Cell Biochem. 2003 Feb 1;88(2):296-307.
3 Zittermann A. Br J Nutr. 2003 May;89(5):552-72.
4 Mezquita-Raya P, et. al. J Bone Miner Res. 2001 Aug;16(8):1408-15.
5 Feskanich D et.al. Am J Clin Nutr. 1999 Jan;69(1):74-9.
6 Booth SL, Suttie JW. J Nutr. 1998 May;128(5):785-8.
7 Watts NB. Clin Chem. 1999 Aug;45(8 Pt 2):1359-68.