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Conclusion Histomorphometric studies have made an important contribution to our understanding of how pharmacologic interventions affect BMD and bone strength in patients with osteoporosis. For antiresorptive agents, the therapeutic effect is mediated predominantly by suppression of bone turnover; in the case of more potent antiresorptive agents, changes in secondary mineralization also occur that...
A variety of in vivo and in vitro experimental models have been used to explore the effects of glucococorticoids in bone. Chronically high levels of glucocorticoids typically decrease bone mass in humans and animals and inhibit markers of bone formation in organ and cell cultures. However, under certain experimental conditions, glucocorticoids can stimulate osteoblast differentiation and bone formation...
Unintentional injuries are the seventh leading cause of death in adults ages 65 and older, and the greatest number of these deaths results from fall-related injuries. In addition to the startling mortality, the morbidity associated with fall-related injuries, particularly hip fractures, has become a research imperative. This article reviews a series of studies that was undertaken to determine the...
The genetic factors that contribute to the susceptibility of osteoporosis are likely to be extremely heterogeneous, reflecting the complex genetic program that controls the cellular aspects of bone formation and remodeling. Because it is unlikely that current genetic methods will have the power to resolve multiple subtle genetic effects from the environmental contribution, biologic approaches will...
A mechanism explaining the differential skeletal effects of intermittent and continuous elevation of serum parathyroid hormone (PTH) remains elusive. Intermittent PTH increases bone formation and bone mass and is being investigated as a therapy for osteoporosis. By contrast, chronic hyperparathyroidism results in the metabolic bone disease osteitis fibrosa characterized by osteomalacia, focal bone...
Osteoporosis is a disease characterized by fragile bones and high susceptibility to low-trauma fractures. It is a serious health problem, especially in elderly women. Bone mineral density (BMD) has been employed most commonly as the index for defining and studying osteoporosis. BMD has high genetic determination, with heritability ranging from 50 to 90%. Various genemapping approaches have been applied...
Significant calcium transfer from the mother to the fetus and infant occurs during pregnancy and lactation, theoretically placing the mother at an increased risk for osteoporosis later in life. During pregnancy, intestinal calcium absorption increases to meet much of the fetal calcium needs. Maternal bone loss also may occur in the last months of pregnancy, a time when the fetal skeleton is rapidly...
To investigate aging bone structure of humans—here, in the lumbar vertebral bodies—requires methodologies that have sufficiently high resolving power yet still have sufficient width and depth of field. No clinical imaging method can come close to meeting the first requirement, leading to the disadvantage of being limited to postmortem studies. Few microscopic methods meet the second and third requisites...
Adolescence is a period of rapid skeletal growth during which nearly half of the adult skeletal mass is accrued. This life stage is a window of opportunity for influencing peak bone mass and reducing the risk of osteoporosis later in life. Endocrine factors that may influence peak bone mass include insulin-like growth factor-1, which regulates skeletal growth, and gonadotropic hormones, which stimulate...
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