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Estrogen and bone. Marshall R. Urist's contributions
Clinical Orthopaedics and Related Research
|November 1, 1985
Summary
Estrogen therapy effectively prevents bone loss and fractures, offering a practical prophylaxis for postmenopausal osteoporosis. This treatment is now widely accepted for managing this common geriatric disorder.
Area of Science:
- Endocrinology
- Bone Biology
- Geriatrics
Background:
- Estrogens play a crucial role in maintaining bone mass.
- Early studies noted species-specific responses to estrogens regarding bone resorption.
- Estrogens are recognized as anticatabolic agents influencing bone metabolism.
Purpose of the Study:
- To review the established role of estrogens in bone mass maintenance.
- To highlight the clinical acceptance of estrogen therapy for osteoporosis.
- To clarify the mechanisms and clinical impact of estrogen's anti-resorptive effects.
Main Methods:
- Review of kinetic and radiographic studies quantifying estrogen's anticatabolic effects.
- Analysis of epidemiological and morphometric data on fracture prevention.
- Examination of in vitro and in vivo studies on estrogen receptor presence and action mediation.
Main Results:
- Estrogens inhibit endosteal resorption and reduce osteoclast numbers.
- Estrogen therapy is clinically accepted for osteoporosis prevention and treatment.
- Fracture prevention by estrogen is morphometrically and epidemiologically established.
- Estrogen's antiosteolytic action is mediated by calcitonin, as bone lacks direct estrogen receptors.
Conclusions:
- Estrogen therapy provides effective and safe prophylaxis for postmenopausal osteoporosis.
- This addresses a significant public health issue, reducing fractures, deformity, and mortality.
- Estrogen's role in bone health management is well-supported by extensive research.