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Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk
Vertebral fractures and trabecular bone loss have dominated thinking and research into the pathogenesis and the structural basis of bone fragility during the last 70 years. However, 80% of all fractures are non-vertebral and occur at regions assembled using large amounts of cortical bone; only 20% o...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Endocrine Society
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722394/ https://www.ncbi.nlm.nih.gov/pubmed/26394727 http://dx.doi.org/10.3803/EnM.2015.30.4.419 |
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author | Seeman, Ego |
author_facet | Seeman, Ego |
author_sort | Seeman, Ego |
collection | PubMed |
description | Vertebral fractures and trabecular bone loss have dominated thinking and research into the pathogenesis and the structural basis of bone fragility during the last 70 years. However, 80% of all fractures are non-vertebral and occur at regions assembled using large amounts of cortical bone; only 20% of fractures are vertebral. Moreover, ~80% of the skeleton is cortical and ~70% of all bone loss is cortical even though trabecular bone is lost more rapidly than cortical bone. Bone is lost because remodelling becomes unbalanced after midlife. Most cortical bone loss occurs by intracortical, not endocortical remodelling. Each remodelling event removes more bone than deposited enlarging existing canals which eventually coalesce eroding and thinning the cortex from 'within.' Thus, there is a need to study the decay of cortical as well as trabecular bone, and to develop drugs that restore the strength of both types of bone. It is now possible to accurately quantify cortical porosity and trabecular decay in vivo. The challenges still to be met are to determine whether measurement of porosity identifies persons at risk for fracture, whether this approach is compliments information obtained using bone densitometry, and whether changes in cortical porosity and other microstructural traits have the sensitivity to serve as surrogates of treatment success or failure. |
format | Online Article Text |
id | pubmed-4722394 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Korean Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-47223942016-01-27 Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk Seeman, Ego Endocrinol Metab (Seoul) Review Article Vertebral fractures and trabecular bone loss have dominated thinking and research into the pathogenesis and the structural basis of bone fragility during the last 70 years. However, 80% of all fractures are non-vertebral and occur at regions assembled using large amounts of cortical bone; only 20% of fractures are vertebral. Moreover, ~80% of the skeleton is cortical and ~70% of all bone loss is cortical even though trabecular bone is lost more rapidly than cortical bone. Bone is lost because remodelling becomes unbalanced after midlife. Most cortical bone loss occurs by intracortical, not endocortical remodelling. Each remodelling event removes more bone than deposited enlarging existing canals which eventually coalesce eroding and thinning the cortex from 'within.' Thus, there is a need to study the decay of cortical as well as trabecular bone, and to develop drugs that restore the strength of both types of bone. It is now possible to accurately quantify cortical porosity and trabecular decay in vivo. The challenges still to be met are to determine whether measurement of porosity identifies persons at risk for fracture, whether this approach is compliments information obtained using bone densitometry, and whether changes in cortical porosity and other microstructural traits have the sensitivity to serve as surrogates of treatment success or failure. Korean Endocrine Society 2015-12 2015-12-31 /pmc/articles/PMC4722394/ /pubmed/26394727 http://dx.doi.org/10.3803/EnM.2015.30.4.419 Text en Copyright © 2015 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Seeman, Ego Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk |
title | Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk |
title_full | Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk |
title_fullStr | Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk |
title_full_unstemmed | Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk |
title_short | Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk |
title_sort | growth and age-related abnormalities in cortical structure and fracture risk |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722394/ https://www.ncbi.nlm.nih.gov/pubmed/26394727 http://dx.doi.org/10.3803/EnM.2015.30.4.419 |
work_keys_str_mv | AT seemanego growthandagerelatedabnormalitiesincorticalstructureandfracturerisk |