Bone health EXPERT Man

When is it advisable to have a test?

The test should be conducted in cases of:

• dull, vague back pain, particularly between the shoulder blades and in the lumbar region,
• as well as reduced or restricted mobility,
• bone pain during everyday activities such as sitting or standing,
• fatigue, weakness, malaise, and joint and muscle pain. 

What´s measured

What are the bones

Bone is a metabolically active organ where there's a continual cycle of old bone breakdown and new bone tissue formation. The whole process is controlled by hormones and growth factors [1,2]. Bones play many important roles in the human body. Changes in bone metabolism can happen at various life stages and might be linked to other conditions, treatments, as well as the natural ageing process. The most widely recognised metabolic bone disorder is osteoporosis [3].

The test should be conducted in cases of dull, vague back pain, particularly between the shoulder blades and in the lumbar region, as well as reduced or restricted mobility, bone pain during everyday activities such as sitting or standing, fatigue, weakness, malaise, and joint and muscle pain. This package is suitable for those who want to check the health of their bones.

What the test of osteoporosis EXPERT Man includes

Bone health EXPERT Man includes basic parameters that provide information about bone metabolism. In addition to determining the levels of calcium, phosphorus, and magnesium, the test includes total level of ALP (alkaline phosphatase) and isoenzymes, ALT and GGT (liver transaminases), albumin, total level of serum proteins, creatinine, glomerular filtration rate (GFR), calcium and phosphorus in urine, and calculated parameters such as fractional excretions for calcium and phosphorus, hormones osteocalcin and vitamin D, prolactin, TSH, PTH, and calcitonin are also measured, along with the inflammation marker CRP (C-reactive protein) and bone markers Beta-CrossLaps and P1NP. The test is complemented by a complete blood count with a differential count.

Calcium

Calcium plays crucial roles in the body. It's responsible for the hardness and strength of human bones, contributes to the proper function of the nervous and muscular systems, and is essential for heart function and blood clotting. The largest reserve of calcium, approximately 99%, is stored in the bones and teeth.

Phosphorus

Phosphorus, in its inorganic form bound as calcium phosphate and hydroxyapatite, constitutes a component of bones and teeth. In its organic form, phosphorus is crucial for the proper functioning of muscles, the nervous system, energy production, and the maintenance of the internal environment of human body.

ALP

ALP, alkaline phosphatase, is an enzyme that influences the metabolism of high-energy phosphate bonds and assists in the transport of inorganic phosphate across the cell membrane. It is mainly found in bone and liver cells.

Blood count with differential

It helps in the assessment of the overall health status, can assist in detecting anemia (low red blood cell count), and thus impaired oxygen supply to tissues, as well as in determining the risk of infections, inflammations, immune disorders, or coagulation problems.

CRP

CRP is one of the acute phase reactants and is a component of the body's immune defense system. As a useful indicator with good dynamics, it is especially helpful in tracking infections/inflammation.

Vitamin D

Vitamin D is a crucial fat-soluble vitamin that serves vital functions in the human body. It's essential for the proper growth and development of bones and teeth, as it stimulates bone formation by activating osteoblasts to synthesise collagen and promotes mineralisation. Deficiency in vitamin D leads to a reduction in calcium content in bone tissue.

Osteocalcin

Osteocalcin serves as an indicator of bone remodelling. It's produced in osteoblasts and chondrocytes, and it binds mineral components such as calcium and hydroxyapatite in organic bone matter.

Urinary calcium

Urinary calcium (its levels) provide information about calcium and vitamin D intake, parathyroid function, chronic kidney disease, osteolysis, or the administration of certain medications.

Urinary phosphorus

Urinary phosphorus levels depend on dietary intake, the balance between tissue synthesis and breakdown, renal function, and various regulatory mechanisms such as the action of vitamin D, parathyroid hormone, calcitonin, fibroblast growth factor (FG), and others.

Fractional excretion

FE, or fractional excretion, indicates the proportion of a substance excreted in the final urine output compared to the total amount filtered. It's used to evaluate tubular function without requiring urine collection.

Creatinine

Creatinine is a waste product, and its blood levels serve as a reliable indicator of kidney function. It's excreted into the urine at a relatively constant rate. Testing creatinine levels enables the detection of kidney function disorders.

Albumin

Albumin, as the primary protein in blood plasma, plays several crucial roles. It's involved in transporting minerals and other substances, maintaining oncotic plasma pressure, and binding toxic heavy metals as well as a variety of drugs.

ALT

ALT is an enzyme present mainly in liver cells. It also plays a role in nitrogen and glucose metabolism, as well as in the formation and breakdown of amino acids.

Prolactin

Prolactin, among other functions, affects calcium metabolism.

TSH

TSH stimulates the production and secretion of thyroid hormones, which in turn stimulate osteoclasts and activate bone remodelling.

PTH

PTH (intact parathyroid hormone) increases the permeability of cells to calcium and phosphate ions, stimulates the production of vitamin D, and promotes the transformation of monocytes into osteoclasts. Its production depends on the concentration of calcium in the blood.

Calcitonin

Calcitonin is involved in bone formation by inhibiting the transformation of monocytes into osteoclasts. It plays a crucial role in regulating calcium and phosphorus metabolism, leading to a reduction in serum calcium levels. ALP isoenzymes—bone ALP isoenzyme reflects the metabolic state of osteoblasts (bone formation).The ratio of individual isoenzymes can be altered even when the total ALP activity is not increased.

Magnesium

Magnesium, among other functions, maintains bone strength and supports normal muscle and nervous system function. It influences the body's absorption of calcium, phosphorus, sodium, and potassium. Magnesium is most abundant in bones, muscles, adipose tissue, red blood cells, and blood serum. Most of the magnesium is reabsorbed in the tubules, which is a process regulated by parathyroid hormone and aldosterone.

GGT

GGT is an enzyme that is highly sensitive to changes in liver function and bile duct damage.

Glomerular filtration rate

The estimated glomerular filtration rate (CKD-EPI eGFR) is one of the key indicators of kidney function. The CKD-EPI equation has been recommended by the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) Task Force since 2021.

P1NP

P1NP, or type 1 procollagen, is synthesised by fibroblasts and osteoblasts and serves as a specific indicator of type 1 collagen deposition in bone, making it a reliable marker of bone formation.

Beta-CrossLaps

Beta-CrossLaps is a fragment of type I collagen used to evaluate bone resorption and monitor osteoclast activity.