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
[41]  
LAMBERG-ALLARDT C, 1989, EUR J CLIN NUTR, V43, P355
[42]   IS THERE A ROLE FOR VITAMIN-D IN OSTEOPOROSIS [J].
LAMBERG-ALLARDT, C .
CALCIFIED TISSUE INTERNATIONAL, 1991, 49 :S46-S49
[43]  
LAZOWSKI D, 1994, BONE, V5, P563
[44]   ABNORMALITIES OF PARATHYROID-HORMONE SECRETION IN ELDERLY WOMEN THAT ARE REVERSIBLE BY SHORT-TERM THERAPY WITH 1,25-DIHYDROXYVITAMIN D-3 [J].
LEDGER, GA ;
BURRITT, MF ;
KAO, PC ;
OFALLON, WM ;
RIGGS, BL ;
KHOSLA, S .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1994, 79 (01) :211-216
[45]   DIFFERENTIAL REGULATION OF INSULIN-LIKE GROWTH FACTOR-I (IGF-I) AND IGF-II RELEASE FROM CULTURED NEONATAL MOUSE CALVARIA BY PARATHYROID-HORMONE, TRANSFORMING GROWTH-FACTOR-BETA, AND 1,25-DIHYDROXYVITAMIN-D3 [J].
LINKHART, TA ;
KEFFER, MJ .
ENDOCRINOLOGY, 1991, 128 (03) :1511-1518
[46]   HISTOMORPHOMETRIC PROFILE AND VITAMIN-D STATUS IN PATIENTS WITH FEMORAL-NECK FRACTURE [J].
LIPS, P ;
NETELENBOS, JC ;
JONGEN, MJM ;
VANGINKEL, FC ;
ALTHUIS, AL ;
VANSCHAIK, CL ;
VANDERVIJGH, WJF ;
VERMEIDEN, JPW ;
VANDERMEER, C .
METABOLIC BONE DISEASE & RELATED RESEARCH, 1982, 4 (02) :85-93
[47]  
Lips P, 1991, Osteoporos Int, V1, P218
[48]   THE EFFECT OF TRAUMA ON SERUM CONCENTRATIONS OF VITAMIN-D METABOLITES IN PATIENTS WITH HIP FRACTURE [J].
LIPS, P ;
BOUILLON, R ;
JONGEN, MJM ;
VANGINKEL, FC ;
VANDERVIJGH, WJF ;
NETELENBOS, JC .
BONE, 1985, 6 (02) :63-67
[49]   THE EFFECT OF VITAMIN-D SUPPLEMENTATION ON VITAMIN-D STATUS AND PARATHYROID FUNCTION IN ELDERLY SUBJECTS [J].
LIPS, P ;
WIERSINGA, A ;
VANGINKEL, FC ;
JONGEN, MJM ;
NETELENBOS, JC ;
HACKENG, WHL ;
DELMAS, PD ;
VANDERVIJGH, WJF .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1988, 67 (04) :644-650
[50]  
LUNGHALL S, 1992, J INTERN MED, V232, P59