Pathophysiology of osteoporosis

R. P. Heaney

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

As with many chronic diseases that express themselves late in life, osteoporosis is distinctly multifactorial, both in etiology and pathophysiology. Osteoporotic fractures occur because of a combination of injury and intrinsic bony fragility. Injury comes most often from a combination of falls, falling to the side, poor postural reflexes that fail to protect bony parts from impact, and reduced soft-tissue padding over bony prominences. The bony fragility itself is a composite of geometry, low mass density, severance of microarchitectural connections in trabecular structures, and altered bone material quality. The latter is primarily the result of accumulated fatigue damage, but reduced collagen cross-links and other intrinsic material defects may play a role as well. Reduced bone mass, in turn, is the result of varying combinations of gonadal hormone deficiency, inadequate intakes of calcium and vitamin D, decreased physical activity, comorbidity, and the effects of drugs used to treat various unrelated medical conditions. Finally, the often poor outcome from hip fracture in the elderly is partly due to associated protein-calorie malnutrition. An adequate preventive program for osteoporotic fracture must address as many of these factors as possible and be as multifaceted as the disease is multifactorial.

Original languageEnglish
Pages (from-to)255-265
Number of pages11
JournalEndocrinology and Metabolism Clinics of North America
Volume27
Issue number2
DOIs
StatePublished - 1998
Externally publishedYes

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Osteoporotic Fractures
Osteoporosis
Preventive Health Services
Gonadal Hormones
Bone and Bones
Protein-Energy Malnutrition
Hip Fractures
Wounds and Injuries
Bone
Vitamin D
Fatigue
Reflex
Comorbidity
Chronic Disease
Collagen
Fatigue damage
Exercise
Calcium
Pharmaceutical Preparations
Tissue

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Endocrinology

Cite this

Pathophysiology of osteoporosis. / Heaney, R. P.

In: Endocrinology and Metabolism Clinics of North America, Vol. 27, No. 2, 1998, p. 255-265.

Research output: Contribution to journalReview article

Heaney, R. P. / Pathophysiology of osteoporosis. In: Endocrinology and Metabolism Clinics of North America. 1998 ; Vol. 27, No. 2. pp. 255-265.
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