biochemical findings in Paget's disease reflect the increased rates
of bone resorption and bone formation. Urinary hydroxyproline, and,
more recently, urinary collagen cross-link excretion correlate with
the extent of skeletal involvement and disease activity. Fasting urinary
calcium/creatinine may be increased when bone resorption significantly
exceeds bone formation. Either total or bone-specific alkaline phosphatase
reflects the overall rate of bone formation. Serum osteocalcin is
a less sensitive index of disease activity.