This osteoporosis panel includes:

• Serum total calcium, albumin (to calculate albumin adjusted calcium) and phosphorus as part of a CMP panel to detect conditions associated with hypercalcemia such as primary hyperparathyroidism or hypocalcemia and consequent secondary hyperparathyroidism causing bone loss
• Serum creatinine and estimated glomerular filtration rate (GFR) as part of the CMP panel are useful to detect renal failure which can affect bone health. 
• Serum alkaline phosphatase (ALP) as part of a CMP panel. ALP measurement is useful to detect conditions including Paget's disease, metastatic bone disease and osteomalacia, etc.
• Vitamin D nutrition should be determined by measuring serum 25-hydroxy vitamin D [25(OH)D]. Although there is controversy about the optimum level of 25(OH)D for bone health; while 50 nmol/L is considered acceptable
• Parathyroid Hormone (PTH) measurement would be required if serum calcium is abnormal, to help investigate the cause of the calcium abnormality.
• Ultra-sensitive Estradiol. Low estradiol in men and women has been linked to bone loss.
• Phosphorus. An increased phosphorus with decreased calcium suggests either hypoparathyroidism or renal disease. A decreased phosphorus and an increased calcium suggests hyperparathyroidism or sarcoidosis. When both calcium and phosphorus are decreased diagnostic considerations include malabsorption, vitamin D deficiency and renal tubular acidosis. Increased phosphorus and normal or increased calcium suggests Milk-alkali syndrome or hypervitaminosis D.

Protein, Gloublin and Albumin - The major proteins seen in the serum are albumin and globulin-the latter being primarily alpha 1 and alpha 2 globulin, beta globulin and gamma globulin. Albumin accounts for more than 50% of the total serum proteins. The albumin to globulin (A/G) ratio has been used as an index of disease state, however, it is not a specific marker for disease because it does not indicate which specific proteins are altered. The normal A/G ratio is 0.8-2.0. The A/G ratio can be decreased in response to a low albumin or to elevated globulins. Total globulins may be increased in some chronic inflammatory diseases (TB, syphilis) multiple myeloma, collagen disease, and rheumatoid arthritis.  Decreased levels are seen in hepatic dysfunction, renal disease and various neoplasms.