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Age-related bone loss and senile osteoporosis: Evidence for both secondary hyperparathyroidism and skeletal growth factor deficiency in the elderly

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Abstract

Aging is characterized by a decrease in bone volume, implying that net bone resorption exceeds net bone formation. This age- related bone loss can be regarded as the main determinant of hip fracture risk in the elderly. In the concept of senile osteoporosis, a key role has been attributed to vitamin D deficiency. Lack of vitamin D activity may affect femoral strength through impaired mineralization as well as through a hyperparathy- roidism- mediated increase in bone resorption. In addition to vitamin D- related mechanisms, recent evidence has indicated a decline in the skeletal content of anabolic growth factors — such as insulin- like growth factor- I (IGF- I) — in femoral (cortical) bone, suggesting that skeletal growth factor deficiency may contribute to the age- related bone loss in the proximal femur as well. It is tempting to speculate that skeletal IGF- I loss might, at least partially, be accounted for by growth hormone deficiency. However, critical evidence does not yet support the concept that the decreased activity of the growth hormone- IGF- I- axis alters bone remodeling, and the extent to which serum concentrations of growth factors are reflective of skeletal activity remains to be clarified.

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  1. Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Brusselsestraat 69, B-3000, Leuven, Belgium

    S. Boonen M.D. & W. Pelemans

  2. Divisions of Rheumatology, University Hospitals Leuven, Leuven, Belgium

    J. Dequeker

  3. Department of Traumatology and Emergency Surgery, University Hospitals Leuven, Leuven, Belgium

    P. Broos

  4. Arthritis and Metabolic Bone Disease Research Unit, University Hospitals Leuven, Leuven, Belgium

    S. Boonen M.D., J. Aerssens & J. Dequeker

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Boonen, S., Aerssens, J., Broos, P. et al. Age-related bone loss and senile osteoporosis: Evidence for both secondary hyperparathyroidism and skeletal growth factor deficiency in the elderly. Aging Clin Exp Res 7, 414–422 (1995). https://doi.org/10.1007/BF03324355

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