Modest associations were found between bone changes on imaging and biochemical markers of bone turnover, evident from a study published in the 'Arthritis Care & Research' journal.  CTX-II was the marker most consistently associated with bone imaging features.

Developing a better understanding of association between biochemical markers and bone changes during imaging such as MRI features may be beneficial for a number of reasons. Therefore, Deveza, L. A  and its colleagues conducted a study to determine the osteoarthritis (OA) association between biochemical markers elaborate in bone turnover and bone features on imaging in the knees.

The evaluated data from the Foundation for the National Institutes of Health OA Biomarkers Consortium within the Osteoarthritis Initiative (n = 600). Bone marrow lesions (BMLs), subchondral bone area (mm2) and osteophytes and shape (position on 3-D vector) were evaluated on magnetic resonance images, and bone trabecular integrity (BTI) was assessed on radiographs. Serum and urinary markers (serum C-terminal cross-linked telopeptide of type I collagen [CTX-I], serum cross-linked N-telopeptide of type I collagen [NTX-I],  urinary C-terminal and urinary NTX-I, crosslinked telopeptide of type II collagen [CTX-II], and urinary CTX-Iα and CTX-Iβ) were assessed. The relationship between biochemical and imaging markers at baseline and over 24 months were evaluated using regression models adjusted for covariates. 

At baseline, most biochemical markers  were related to BMLs, with C statistics for the presence/absence of any BML vary from 0.675 to 0.688. Initial, urinary CTX-II was the marker most related continuously to BMLs (with odds of having ≥5 subregions over-elaborate differentiate to no BML increasing by 1.92-fold [95% confidence interval (95% CI) 1.25, 2.96] per 1 SD of urinary CTX-II). Large osteophytes (odds ratio 1.39 [95% CI 1.10, 1.77]), shape (highest partial R2 = 0.032) and bone area, and revolution in bone shape were over 24 months (partial R2 range 0.008 to 0.024). Overall, biochemical markers were not predicting modifications in BMLs or osteophytes, and Serum NTX-I was inversely related.

The investigated multiple significant associations, albeit mostly weak ones. Based on study findings,  the role of systemic biochemical markers as predictors of individual bone anatomic features of single knees is limited.