Journal September 19, 2026 4 min read

What markers track bone remodelling?

Bone remodelling is tracked by biochemical markers of formation and resorption, including osteocalcin carboxylation states, microRNAs, and imaging or histomorphometric endpoints. This page summarises the markers and mode

peptides-pro Editorial

Bone remodelling is tracked by biochemical markers of bone formation and bone resorption, together with imaging and histomorphometric endpoints. In the evidence supplied here, the markers studied include circulating osteocalcin carboxylation states as indices of vitamin K status and skeletal fragility [1], microRNAs and markers of therapeutic response to romosozumab and abaloparatide in postmenopausal osteoporosis [2], and radiographic, histomorphometric and biomarker measures after maxillary sinus augmentation with a xenograft particulate bone graft mixed with parathyroid hormone [3].

The work centres on pathways and receptor families relevant to bone turnover: vitamin K–dependent carboxylation of osteocalcin [1], sclerostin inhibition and parathyroid hormone receptor signalling [2], and parathyroid hormone effects on bone regeneration and remodelling [3].

Research Studies

Osteocalcin carboxylation states and skeletal fragility in arthroplasty patients

A prospective cross-sectional case-control study enrolled 108 patients undergoing arthroplasty (hip-fracture, n = 63; non-fracture, n = 45) and collected bone biopsies and blood specimens intraoperatively [1]. The study examined the incremental contribution of six pathway-specific nutritional biomarkers, including circulating biomarkers reflecting vitamin K, one-carbon metabolism, and antioxidant nutrients (vitamins E and C) [1]. The authors noted that the contribution of specific nutritional biomarkers to skeletal fragility remains poorly understood, in part because most studies include participants with metabolic conditions that obscure nutrient-specific effects [1].

MicroRNA and markers of therapeutic response to romosozumab and abaloparatide in postmenopausal osteoporosis

A registered study is evaluating microRNA and markers of therapeutic response to romosozumab and abaloparatide in postmenopausal osteoporosis [2]. Osteoporosis is described as a systemic skeletal disorder affecting approximately 10% of individuals over 50 years of age, characterised by an increased risk of fragility fractures [2]. Approved pharmacological therapies include anabolic agents that stimulate osteoblast-mediated bone formation (teriparatide, abaloparatide), antiresorptive agents that inhibit osteoclast-driven bone resorption (bisphosphonates, denosumab), and dual-action agents such as romosozumab, which acts through sclerostin inhibition [2].

Parathyroid hormone combined with xenograft in maxillary sinus augmentation

A study is investigating the effect of combining parathyroid hormone with bovine-derived bone graft in maxillary sinus augmentation [3]. The authors state that there is limited information available about the effect of parathyroid hormone on maxillary sinus augmentation, and that a clear understanding of its efficacy in bone regeneration and bone remodelling requires radiological, clinical, biomarker, histological and histomorphometric assessment [3]. The objectives include evaluation of bone density at planned implant sites using cone beam computed tomography (CBCT), and histomorphometric examination of maxillary sinus bone to measure bone trabeculae, connective tissue, osteoblast and osteocyte after healing 4 months after the procedure [3].

Markers and models compared

Marker or endpoint	Model or population	Source
Osteocalcin carboxylation states; vitamin K, one-carbon metabolism, vitamins E and C biomarkers	Patients undergoing arthroplasty (hip-fracture, n = 63; non-fracture, n = 45)	[1]
MicroRNA and markers of therapeutic response	Postmenopausal osteoporosis	[2]
CBCT bone density; histomorphometry (bone trabeculae, connective tissue, osteoblast, osteocyte); biomarkers	Maxillary sinus augmentation with xenograft plus parathyroid hormone	[3]

Vitamin K status and skeletal fragility

The arthroplasty study aimed to examine the incremental contribution of six pathway-specific nutritional biomarkers to skeletal fragility, using bone biopsies and blood specimens collected intraoperatively [1]. The design was a prospective cross-sectional case-control study [1].

Anabolic, antiresorptive and dual-action therapies

The osteoporosis study describes approved therapies as anabolic agents that stimulate osteoblast-mediated bone formation (teriparatide, abaloparatide), antiresorptive agents that inhibit osteoclast-driven bone resorption (bisphosphonates, denosumab), and dual-action agents such as romosozumab, which acts through sclerostin inhibition [2].

Radiological and histomorphometric assessment in sinus augmentation

The sinus augmentation study uses cone beam computed tomography (CBCT) to evaluate bone density at planned implant sites, and histomorphometry to measure bone trabeculae, connective tissue, osteoblast and osteocyte after healing 4 months after the procedure [3].

Biomarker assessment in bone regeneration

The sinus augmentation study includes biomarker assessment alongside radiological, clinical, histological and histomorphometric assessment to understand the efficacy of parathyroid hormone in bone regeneration and bone remodelling [3].

MicroRNA as markers in postmenopausal osteoporosis

The registered study evaluates microRNA and markers of therapeutic response to romosozumab and abaloparatide in postmenopausal osteoporosis [2].

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