[Pathogenesis of fracture will be important in the research work of osteoporosis]

Osteoporosis is characterized by compromised bone strength, and the increased susceptibility to fractures that impair patient's quality of life and increase mortality constitutes a national burden in the aging society. The pathogenesis of osteoporosis has been recently astringent on estrogen deficiency that induces secondary metabolic changes such as calcium imbalance. Thus, the main research issue in osteoporosis has been turning to the mechanical basis of bone fractures. According to the definition of osteoporosis proposed by National Institutes of Health, bone strength reflects the integration of two components: the bone mass (bone mineral density) and bone quality. Of the two, bone mineral density (BMD) is known to be the major determinant of future fracture risk. In contrast, bone quality assessment has not been applied to clinical practice except for the measurement of bone turnover markers. The present paper reviewed the bone quality concepts and discussed the future potential research propositions.