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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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Bone Disorders01:29

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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.
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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Role of Vitamins in Maintaining Bone Health01:25

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The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
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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.
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The minerals contained in all of the food we consume are essential for our organ systems. However, certain essential minerals, such as calcium, phosphorus, magnesium, manganese, and fluoride, largely affect bone health.
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Related Experiment Video

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A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders
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Recent Advances in Osteoporosis Therapeutics.

Anne Sophie Sølling1, Bente L Langdahl1,2, Felicia Cosman3

  • 1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.

Annual Review of Medicine
|November 18, 2025
PubMed
Summary

Postmenopausal osteoporosis, linked to estrogen loss and aging, often goes undiagnosed and untreated. Current and emerging therapies aim to improve fracture prevention and bone density for better long-term management.

Keywords:
antiresorptivesdual actiongoal-directed therapyosteoanabolicpostmenopausal osteoporosis

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Area of Science:

  • Endocrinology
  • Gerontology
  • Bone Biology

Background:

  • Postmenopausal osteoporosis is a progressive condition driven by estrogen deficiency, aging, and genetic/environmental factors.
  • A significant number of patients remain undiagnosed and undertreated, highlighting a gap in care.
  • Estrogen deficiency at menopause is a primary driver of bone loss.

Purpose of the Study:

  • To review current and emerging therapeutic strategies for postmenopausal osteoporosis.
  • To emphasize the importance of risk stratification and individualized treatment approaches.
  • To discuss the potential of novel treatments for enhancing bone health.

Main Methods:

  • Review of current antiresorptive and osteoanabolic therapies.
  • Discussion of sequential treatment strategies.
  • Analysis of recent guidelines for risk stratification and goal-directed therapy.

Main Results:

  • Established therapies include bisphosphonates, denosumab, raloxifene (antiresorptive), and teriparatide, abaloparatide, romosozumab (osteoanabolic).
  • Sequential therapies are crucial for optimizing long-term fracture prevention and bone density.
  • Individualized, goal-directed strategies are recommended based on risk stratification.

Conclusions:

  • Effective management of postmenopausal osteoporosis requires a comprehensive approach.
  • Current therapies offer options for antiresorption and bone formation.
  • Ongoing research and new treatments promise further advancements in managing this condition.