Overview of Osteoporosis: Pathophysiology and Determinants of Bone Strength

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2003 Sep 19

PMID 13680312

Citations 15

Authors

Christopher M Bono

Thomas A Einhorn

Affiliations

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Abstract

Recent advances in both the pharmacological and surgical treatment of osteoporosis and vertebral compression fractures offer exciting new options for elderly patients. However, these treatments should be considered only with an indepth knowledge of osteoporosis as a metabolic disorder with complex effects on bone, its homeostatic regulation, and vertebral strength. Bone homeostasis is under the influence of both endogenous hormonal changes and external mechanical loads resulting from physical activity. These impart their effects through regulation of the relative activities of bone cells, in particular osteoblasts and osteoclasts, which control bone deposition and resorption, respectively. The strength of a vertebra is directly influenced by the amount and relative proportions of its components, with bone mineral density a useful measure of fracture risk. The purpose of this article is to discuss these issues, among others, in order to offer the reader a better understanding of the pathophysiology of osteoporosis and the determinants of bone strength as they relate to the aging skeleton.

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References

Leidig-Bruckner G, Minne H, Schlaich C, Wagner G, Scheidt-Nave C, Bruckner T . Clinical grading of spinal osteoporosis: quality of life components and spinal deformity in women with chronic low back pain and women with vertebral osteoporosis. J Bone Miner Res. 1997; 12(4):663-75. DOI: 10.1359/jbmr.1997.12.4.663. View

Riggs B, Melton 3rd L . Evidence for two distinct syndromes of involutional osteoporosis. Am J Med. 1983; 75(6):899-901. DOI: 10.1016/0002-9343(83)90860-4. View

Norman A, Roth J, Orci L . The vitamin D endocrine system: steroid metabolism, hormone receptors, and biological response (calcium binding proteins). Endocr Rev. 1982; 3(4):331-66. DOI: 10.1210/edrv-3-4-331. View

Feskanich D, Willett W, Colditz G . Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA. 2002; 288(18):2300-6. DOI: 10.1001/jama.288.18.2300. View

Eastell R, Lambert H . Strategies for skeletal health in the elderly. Proc Nutr Soc. 2002; 61(2):173-80. DOI: 10.1079/PNS2002160. View

Kerstetter J, OBrien K, Insogna K . Low protein intake: the impact on calcium and bone homeostasis in humans. J Nutr. 2003; 133(3):855S-861S. DOI: 10.1093/jn/133.3.855S. View

Gur A, Denli A, Nas K, Cevik R, Karakoc M, Sarac A . Possible pathogenetic role of new cytokines in postmenopausal osteoporosis and changes during calcitonin plus calcium therapy. Rheumatol Int. 2002; 22(5):194-8. DOI: 10.1007/s00296-002-0223-x. View

Silva M, Keaveny T, Hayes W . Load sharing between the shell and centrum in the lumbar vertebral body. Spine (Phila Pa 1976). 1997; 22(2):140-50. DOI: 10.1097/00007632-199701150-00004. View

Flynn M, Cody D . The assessment of vertebral bone macroarchitecture with X-ray computed tomography. Calcif Tissue Int. 1993; 53 Suppl 1:S170-5. DOI: 10.1007/BF01673430. View

10.

Vega E, Ghiringhelli G, Mautalen C, Valzacchi G, SCAGLIA H, Zylberstein C . Bone mineral density and bone size in men with primary osteoporosis and vertebral fractures. Calcif Tissue Int. 1998; 62(5):465-9. DOI: 10.1007/s002239900462. View

11.

de Laet C, van der Klift M, Hofman A, Pols H . Osteoporosis in men and women: a story about bone mineral density thresholds and hip fracture risk. J Bone Miner Res. 2002; 17(12):2231-6. DOI: 10.1359/jbmr.2002.17.12.2231. View

12.

Lacey D, Timms E, Tan H, Kelley M, Dunstan C, Burgess T . Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell. 1998; 93(2):165-76. DOI: 10.1016/s0092-8674(00)81569-x. View

13.

Amling M, Schilling A, Haberland M, Rueger J . [Leptin: factor in the central nervous system regulation of bone mass. Development of a new understanding of bone remodeling, skeletal reconstruction, skeletal preservation and skeletal repair]. Orthopade. 2001; 30(7):418-24. DOI: 10.1007/s001320170072. View

14.

Riggs B, Melton 3rd L . The prevention and treatment of osteoporosis. N Engl J Med. 1992; 327(9):620-7. DOI: 10.1056/NEJM199208273270908. View

15.

Einhorn T . Bone strength: the bottom line. Calcif Tissue Int. 1992; 51(5):333-9. DOI: 10.1007/BF00316875. View