Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- 14 Consequences of alterations in bone remodeling
- 15 The role of parathyroid hormone and hyperparathyroidism in osteoporosis
- 16 Senile Osteoporosis
- Part IV Clinical aspects of osteoporosis
- Index
14 - Consequences of alterations in bone remodeling
Published online by Cambridge University Press: 01 June 2011
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- 14 Consequences of alterations in bone remodeling
- 15 The role of parathyroid hormone and hyperparathyroidism in osteoporosis
- 16 Senile Osteoporosis
- Part IV Clinical aspects of osteoporosis
- Index
Summary
The key to understanding the pathogenesis of osteoporosis is an analysis of the bone remodeling process and of the mechanisms by which alterations in this process can lead to loss of bone mass and strength. Our knowledge of bone remodeling at the cellular and molecular level has increased greatly, but we still lack critical information on the factors which regulate bone remodeling in humans and which are likely to be responsible for bone loss. While the initial formation of the skeleton depends on direct apposition of new bone, or modeling, remodeling of the skeleton begins in early fetal life and becomes the dominant metabolic activity of the skeleton by the end of puberty.
During childhood and adolescence, rapid rates of bone remodeling are associated with a gain in bone mass. Once peak bone mass has been achieved, there is a period when skeletal remodeling remains in balance; that is, the rates of resorption and formation are relatively equal, or tightly ‘coupled.’ Bone loss probably begins before the menopause in women, but then accelerates at the menopause. Bone loss in men has not been clearly defined, but probably occurs at a slow rate beginning in the 50s and 60s and at an accelerated rate thereafter.
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- Information
- The Osteoporosis Primer , pp. 199 - 210Publisher: Cambridge University PressPrint publication year: 2000
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