A Systematic Review of the Circadian Rhythm of Bone Markers in Blood

source extracted confidence: high 2026-04-09
#circadian-rhythm #bone-and-bones #collagen-type-i #biomarkers #osteocalcin

A Systematic Review of the Circadian Rhythm of Bone Markers in Blood

Diemar et al., 2023 | Calcif Tissue Int | Systematic Review

Citation

Diemar Sarah Seberg, Dahl Stig Søgaard, ... Jørgensen Niklas Rye. A Systematic Review of the Circadian Rhythm of Bone Markers in Blood. Calcif Tissue Int. 2023-Feb;112(2):126-147. doi:10.1007/s00223-022-00965-1

Abstract

There exists a marked circadian variation for several bone markers (BM), which is influenced by endogenous as well as exogenous factors including hormones, physical activity, and fasting. Consequently, was the aim of this review to provide an overview of the knowledge of the circadian variation of BM and which factors influence this rhythmicity. A systematic search of PubMed was performed for studies evaluating the circadian variation of BM and which factors influence this rhythmicity. The studies were screened for eligibility by a set of predetermined criteria including a list of relevant BM and a minimum study duration of 24 h with at least 3 blood samples of which two should be at least 6 h apart. In total were 29 papers included. There exists a marked circadian variation for most BM including Carboxy-terminal Cross-Linked Telopeptide of Type I Collagen (CTX) and osteocalcin (OC) with nighttime or early morning peak. Pro-collagen Type I N-terminal Propeptide (PINP) and PTH also showed circadian rhythm but with less amplitude. The inter-osteoblast-osteoclast regulatory markers such as OPG, RANKL, FGF23, and sclerostin showed no circadian rhythm. The markers were differently affected by exogenous factors like fasting, which greatly reduced the circadian variation of CTX but did not affect PINP or OC. The marked circadian variation and the factors which influence the rhythmicity, e.g., fasting are of great consequence when measuring BM. To reduce variation and heighten validity should circadian variation and fasting be kept in mind when measuring BM.

Key Findings

To reduce variation and heighten validity should circadian variation and fasting be kept in mind when measuring BM.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Circadian Rhythm
  • Bone and Bones
  • Collagen Type I
  • Biomarkers
  • Osteocalcin

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09