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Related Concept Videos

Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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Changes in the Appendicular Skeleton with Age01:09

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The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
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Compact Bone01:27

Compact Bone

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Most bones contain compact and spongy osseous tissue, but their distribution and concentration vary based on the bone's overall function.
Compact bone, also called cortical bone, is the denser, stronger of the two types of bone tissue. It is found under the periosteum and in the diaphyses of long bones, where it provides support and protection. The microscopic structural unit of compact bone is called an osteon, or haversian system. Each osteon is composed of concentric rings of calcified...
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Gross Anatomy of Bone01:17

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The two main features of a long bone are the diaphysis and the epiphysis.
The diaphysis is the tubular shaft that runs between the proximal and distal ends of the bone. The walls of the diaphysis are composed of dense and hard compact bone made of numerous osteons — the functional unit of the compact bone. The hollow region in the diaphysis is called the medullary cavity, which harbors the bone marrow. In infants and children, this marrow cavity is filled with red marrow, whereas in...
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Osteoclasts in Bone Remodeling01:31

Osteoclasts in Bone Remodeling

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Hormones and Bone Tissue01:17

Hormones and Bone Tissue

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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[Bone quality in patients with acromegaly].

Martin Kužma, Ivana Ságová, Dušan Pavai

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    Acromegaly patients show increased bone turnover and a high risk of vertebral fractures, independent of bone mineral density. Research now focuses on bone quality and microstructure to understand fracture risks.

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    Area of Science:

    • Endocrinology
    • Orthopedics
    • Bone Biology

    Background:

    • Acromegaly, caused by growth hormone (GH) hypersecretion, significantly impacts bone metabolism.
    • The relationship between acromegaly, bone density, and fracture risk remains incompletely understood.
    • Elevated GH levels stimulate bone turnover, influencing bone mineral density (BMD) and microstructure.

    Purpose of the Study:

    • To investigate the impact of acromegaly on bone health and fracture risk.
    • To explore the factors contributing to vertebral fractures in acromegaly patients.
    • To highlight the shift in research focus towards bone quality and microstructure.

    Main Methods:

    • Review of existing literature on acromegaly, bone turnover markers, BMD, and fracture incidence.
    • Analysis of factors associated with vertebral fractures, including hypogonadism and diabetes mellitus.
    • Examination of studies focusing on bone quality, strength, and microstructure in acromegaly.

    Main Results:

    • Acromegaly is associated with increased bone turnover and a notable prevalence of morphometric vertebral fractures (VF) in approximately one-third of patients.
    • While BMD may be normal or increased, specific risk factors like hypogonadism, diabetes mellitus, and prior VF increase fracture likelihood.
    • Fracture risk in acromegaly does not consistently correlate with BMD, emphasizing the importance of bone quality.

    Conclusions:

    • Acromegaly poses a significant risk for vertebral fractures, often unrelated to bone mineral density.
    • Hypogonadism, diabetes mellitus, and a history of fractures are key risk factors for vertebral fractures in acromegaly.
    • Future research should prioritize evaluating bone microstructure and quality to better predict and manage fracture risk in acromegaly.