Abstract
The morbidity; mortality, and cost of involutional osteoporosis result largely from the associated fractures,1 and pathogenesis must be considered in that context (Figure 7.1). This chapter will review the determinants of bone fragility that result from low peak bone mass and from subsequent bone loss due to the menopause in women, to aging in both genders, and to the various causes of secondary osteoporosis. The role of trauma will be described as it relates to the frequency and severity of falls. Finally, the heterogeneity of osteoporosis syndromes will be discussed, with emphasis on current concepts of Type I (postmenopausal) and Type II (age-related) osteoporosis.
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References
Melton LJ. Epidemiology of fractures. In: Riggs BL, Melton LJ, eds. Osteoporosis: Etiology, Diagnosis, and Management. New York: 17. Raven Press; 1988: 133–54.
Melton LJ, Chao EYS, Lane J. Biomechanical aspects of fractures. In: Riggs BL, Melton LJ, eds. Osteoporosis: Etiology, Diagnosis, and 18. Management. New York: Raven Press; 1988: 111–31.
Hui SL, Slemenda CW, Johnston CC Jr. The contribution of bone loss to postmenopausal 19. osteoporosis. Osteoporosis Int. 1990; 1: 30–34.
Riggs BL, Melton LJ. Medical progress: involutional osteoporosis. N Engl J Med. 1986; 314: 1676–84.
Melton LJ. Differing patterns of osteoporosis 20. across the world. Excerpta Medica. In Press.
Burckhardt P, Michel CH. The peak bone 21. mass concept. Clinical Rheumatol. 1989; 8 (Suppl. 2): 16–21.
Sowers MF, Wallace, RB, Lemke, JH. Correlates of forearm bone mass among women during maximal bone mineralization. Prey Med. 1985; 14: 585–596.
Drinkwater BL, Bruemner B, Chestnut CH. 23. Menstrual history as a determinant of current bone density in young athletes. JAMA. 1990; 263: 545–548.
Kelly PJ, Eisman JA, Sambrook PN. Interac- 24. tion of genetic and environmental influences on peak bone density. Osteoporosis Int. 1990; 1: 56–60.
Peck WA, Riggs BL, Bell NH, et al. Research directions in osteoporosis. Am J Med. 1988; 84: 275–82.
Riggs BL, Melton LJ. Involutional osteoporosis. In: Oxford Textbook of Geriatric Medicine. JG Evans, TF Williams (Eds). Oxford University Press, Oxford, 1992: 405–411.
Kanis JA, Passmore R. Calcium supplementation of the diet, II: not justified by present evidence. Br Med J. 1989; 298: 205–8.
Pocock N, Eisman J, Gwinn T, et al. Muscle strength, physical fitness, and weight but not age predict femoral neck bone mass. J Bone Min Res. 1989; 4: 441–8.
Krolner B, Toft B. Vertebral bone loss: an unheeded side effect of therapeutic bed rest. Clin Sci. 1983; 64: 537–40.
Eriksen EF, Colvard DS, Berg NJ, et al. Evidence of estrogen receptors in normal human osteoblast-like cells. Science. 1988; 241: 84–86.
Seeman E, Melton LJ, O’Fallon WM, Riggs BL. Risk factors for spinal osteoporosis in men. Am J Med. 1983; 75: 977–983.
Melton LJ, Riggs BL. Clinical spectrum. In: Riggs BL, Melton LJ, eds. Osteoporosis: Etiology, Diagnosis, and Management. New York: Raven Press; 1988: 155–79.
Gryfe CI, Amies A, Ashley MJ. A longitudinal study of falls in an elderly population: I. Incidence and morbidity. Age Aging. 1977; 6: 201–210.
Cummings SR, Nevitt MC. Epidemiology of hip fractures and falls. In: Kleerekoper M, Krane SM, eds. Clinical Disorders of Bone and Mineral Metabolism. New York: Mary Ann Liebert, Inc. 1989: 231–236.
Gibson MJ. The prevention of falls in later life. Danish Med Bull. 1987; 34 (Suppl. 4): 1–24.
Melton, LJ, Riggs BL. Risk factors for injury after a fall. Clin Geriatr Med. 1985; 1: 525–539.
Hayes WC, Myers ER, Morris JN, et al. Fall biomechanics as determinants of osteoporotic hip fracture risk. Proceedings of the Nineteenth Steenbock Symposium on Osteoporosis, Madison, WI, June 4–7, 1989.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988; 319: 1701–7.
Melton LJ, Riggs BL. Further characterization of the heterogeneity of the osteoporotic syndromes. In: M Kleerekoper, Krane SM, eds. Proceedings of the International Symposium on Clinical Disorders of Bone and Mineral Metabolism. New York: Mary Ann Liebert, Inc.; 1989: 145–152.
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© 1994 Springer-Verlag New York, Inc.
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Melton, L.J. (1994). Pathogenesis of Osteoporosis. In: Lorrain, J., Plouffe, L., Ravnikar, V.A., Speroff, L., Watts, N.B. (eds) Comprehensive Management of Menopause. Clinical Perspectives in Obstetrics and Gynecology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4330-4_8
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DOI: https://doi.org/10.1007/978-1-4612-4330-4_8
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