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Postmenopausal osteoporosis.

Richard Eastell1, Terence W O'Neill2, Lorenz C Hofbauer3

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Nature Reviews. Disease Primers
|September 30, 2016
PubMed
Summary
This summary is machine-generated.

Osteoporosis is a bone disorder causing low bone mass and deterioration, increasing fracture risk, especially in older women. Prevention includes lifestyle changes and medications targeting bone resorption or formation.

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Area of Science:

  • Bone Biology and Metabolism
  • Geriatric Medicine
  • Public Health

Background:

  • Osteoporosis is a metabolic bone disorder defined by low bone mass and deteriorating bone tissue microarchitecture.
  • It leads to fragility fractures, particularly in the proximal femur, vertebrae, and distal radius, posing a significant public health challenge due to an aging population.
  • Postmenopausal osteoporosis, driven by estrogen deficiency, elevates bone turnover, disrupting the balance between bone formation and resorption, affecting both trabecular and cortical bone structure.

Approach:

  • Diagnosis relies on bone density measurements of the lumbar spine and proximal femur.
  • Preventive measures encompass lifestyle modifications like diet, exercise, and smoking cessation.
  • Fall prevention strategies are crucial for high-risk populations to mitigate fracture incidence.

Key Points:

  • Estrogen deficiency in postmenopausal women significantly increases bone turnover, leading to bone loss.
  • Osteoporotic changes include loss of connectivity in trabecular bone and thinning/porosity in cortical bone.
  • Current treatments include bisphosphonates and denosumab to slow bone resorption, and teriparatide to stimulate bone formation.

Conclusions:

  • Osteoporosis is a major health concern, particularly for women over 50, with fractures severely impacting quality of life.
  • Effective management involves early diagnosis, preventive strategies, and pharmacotherapy.
  • Ongoing research into the cellular mechanisms of osteoporosis is driving the development of novel therapeutic agents.