Atlas of Postmenopausal Osteoporosis, 3rd Edition by Rene Rizzoli

By Rene Rizzoli

René Rizzoli Menopause is the time in a woman’s existence whilst reproductive capability ends. Ovaries lessen their job and the construction of intercourse hormones ceases. this era will be linked to a wide number of indicators affecting the cardiovascular and urogenital structures, in addition to pores and skin, hair and bone. Bone capital is gathered through the tip of the second one decade and continues to be kind of consistent as much as the time of menopause. intercourse hormone deficiency ends up in speeded up bone turnover, a detrimental stability and microarchitectural deterioration, which compromises bone power, thereby expanding bone fragility and, therefore, fracture probability. by way of the age of eighty, it truly is anticipated that fifty% of trab- ular bone could have been misplaced. ordinary menopause happens among the a while of forty five and fifty four years worldwide. This age doesn't seem to have replaced considerably over the centuries. against this, because the center of the nineteenth century, lifestyles expectancy, quite in ladies, has elevated significantly, with most girls residing to the age of eighty years or extra in lots of areas of the realm. which means on the age of fifty years, a lady will reside for greater than 30 years with out bone safety by means of intercourse hormones. This r- resents greater than one-third of a woman’s lifestyles. on the age of fifty years, the lifetime danger to event a fracture is ready 50% (ie, one out of 2 girls can have a fracture in this period).

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Lancet 1976; 1:1038–41. Lips P, Hosking D, Lippuner K et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med 2006; 260:245–54. Manolagas SC. Birth and death of bone cells: basic regulatory mechanisms and implications for the pathogenesis and treatment of osteoporosis. Endocr Rev 2000; 21:115–37. Marcus R. The nature of osteoporosis. In: Osteoporosis. Edited by R Marcus, D 31 Atlas of Postmenopausal Osteoporosis Pathophysiology of Postmenopausal Osteoporosis Feldman, J Kelsey.

Number of years since menopause: spontaneous bone loss is dependent but response to hormone replacement therapy is independent. Boivin G, Meunier PJ. Methodological considerations in measurement of bone mineral content. Osteoporos Int 2003; 14(Suppl 5):S22–8. Bonewald LF. Osteocytes as dynamic multifunctional cells. Ann N Y Acad Sci 2007; 1116:281–90. Bonjour JP, Rizzoli R. Bone acquisition in adolescence. In: Osteoporosis, volume 1, 2nd edition. Edited by R Marcus, J Kelsey, D Feldman. San Diego: Academic Press, 2001; 621–38.

The gray levels indicate patchy differences of mineralization, with white representing the highest level of mineralization. (a) and (b) Courtesy of J Kosek, Stanford University School of Medicine, Stanford, California, USA. (c) Reproduced with permission from Marcus R. The nature of osteoporosis. In: Osteoporosis. Edited by R Marcus, D Feldman, J Kelsey. San Diego: Academic Press, 1996; 647–59. 22. Basic mechanisms resulting in accelerated bone loss in postmenopausal women. (a) Starting in the perimenopause when menstrual cycles become irregular and culminating at the menopause when ovarian function ceases, levels of estradiol drop abruptly.

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