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

被引:9
作者
Boonen, S
Aerssens, J
Broos, P
Pelemans, W
Dequeker, J
机构
[1] Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Leuven, B-3000
[2] Divisions of Rheumatology, University Hospitals Leuven, Leuven
[3] Department of Traumatology and Emergency Surgery, University Hospitals Leuven, Leuven
[4] Arthritis and Metabolic Bone Disease Research Unit, University Hospitals Leuven, Leuven
关键词
age-related bone loss; senile osteoporosis; secondary hyperparathyroidism; skeletal growth factor deficiency;
D O I
10.1007/BF03324355
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
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 par tially, be accounted for by growth hormone defi ciency. 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.
引用
收藏
页码:414 / 422
页数:9
相关论文
共 90 条
[1]   IMPAIRMENT OF BONE TURNOVER IN ELDERLY WOMEN WITH HIP FRACTURE [J].
AKESSON, K ;
VERGNAUD, P ;
GINEYTS, E ;
DELMAS, PD ;
OBRANT, KJ .
CALCIFIED TISSUE INTERNATIONAL, 1993, 53 (03) :162-169
[2]   EFFECTS OF PROGESTIN-OPPOSED TRANSDERMAL ESTROGEN ADMINISTRATION ON GROWTH-HORMONE AND INSULIN-LIKE GROWTH FACTOR-I IN POSTMENOPAUSAL WOMEN OF DIFFERENT AGES [J].
BELLANTONI, MF ;
HARMAN, SM ;
CHO, DE ;
BLACKMAN, MR .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1991, 72 (01) :172-178
[3]  
BLUNT BA, 1994, J BONE MINER RES, V9, P1333
[4]   GROWTH-HORMONE AND BONE [J].
BOUILLON, R .
HORMONE RESEARCH, 1991, 36 :49-55
[5]   VITAMIN-D STATUS IN THE ELDERLY - SEASONAL SUBSTRATE DEFICIENCY CAUSES 1,25-DIHYDROXYCHOLECALCIFEROL DEFICIENCY [J].
BOUILLON, RA ;
AUWERX, JH ;
LISSENS, WD ;
PELEMANS, WK .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1987, 45 (04) :755-763
[6]   THE ASSOCIATION BETWEEN AGE AND BONE-MINERAL DENSITY IN MEN AND WOMEN AGED 55 YEARS AND OVER - THE ROTTERDAM STUDY [J].
BURGER, H ;
VANDAELE, PLA ;
ALGRA, D ;
VANDENOUWELAND, FA ;
GROBBEE, DE ;
HOFMAN, A ;
VANKUIJK, C ;
SCHUTTE, HE ;
BIRKENHAGER, JC ;
POLS, HAP .
BONE AND MINERAL, 1994, 25 (01) :1-13
[7]   INVOLVEMENT OF THE PLASMIN SYSTEM IN DISSOCIATION OF THE INSULIN-LIKE GROWTH FACTOR-BINDING PROTEIN COMPLEX [J].
CAMPBELL, PG ;
NOVAK, JF ;
YANOSICK, TB ;
MCMASTER, JH .
ENDOCRINOLOGY, 1992, 130 (03) :1401-1412
[8]   GROWTH-FACTORS AND THEIR POTENTIAL CLINICAL-VALUE [J].
CANALIS, E .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1992, 75 (01) :1-4
[9]   GROWTH-FACTORS AND THE REGULATION OF BONE REMODELING [J].
CANALIS, E ;
MCCARTHY, T ;
CENTRELLA, M .
JOURNAL OF CLINICAL INVESTIGATION, 1988, 81 (02) :277-281
[10]   EDITORIAL - SKELETAL GROWTH-FACTORS AND AGING [J].
CANALIS, E .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1994, 78 (05) :1009-1010