Global survey reveals major variation in the measurement of bone and mineral metabolism biomarkers

A recent international survey conducted by the International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Joint Committee on Bone Metabolism has uncovered significant inconsistencies in the methods used by laboratories worldwide to measure bone status indices (BSIs) in blood tests.

The study, published in Clinical Chemistry and Laboratory Medicine on August 7, 2026, collected responses from 231 laboratories across 41 countries. Despite efforts by IOF and IFCC for over two decades to standardize BSI nomenclature, abbreviations, and measurement units, the findings reveal a lack of harmonization that hampers data sharing, standardization, and clinical impact.

These inconsistencies in reference intervals, decision thresholds, and quality assessment for bone turnover markers limit the comparability of research data and can adversely affect clinical decision-making. Professor Etienne Cavalier, chair representing IOF on the joint committee, emphasized that the lack of harmonization extends beyond laboratory practices, impacting research data comparability and clinical decisions.

Professor Eugene McCloskey, chair of the IOF Committee of Scientific Advisors, highlighted that simple measures such as improved clinical terminology and laboratory reporting could enhance the clinical utility of BSI testing, facilitating data sharing and ultimately supporting better patient care.