Author/Editor		Završnik, Matej
Title		Epidemiologija in patogeneza osteoporoze
Translated title		Epidemiology and pathogenesis of osteoporosis
Type		članek
Source		In: Hojs R, Krajnc I, Pahor A, et al, editors. Iz prakse za prakso. Zbornik predavanj in praktikum 16. srečanje internistov in zdravnikov splošne medicine z mednarodno udeležbo; 2005 maj 20-21; Maribor. Maribor: Splošna bolnišnica Maribor,
Publication year		2005
Volume		str. 23-38
Language		slo
Abstract		Osteoporosis is a global problem increasing with the aging of the population. The fracture is its major clinical manifestation. Osteoporosis is determined by mineral bone density measurement, which is a good predictor of future fractures. This risk increases steeply with age and is double for women in general. Typical osteoporosis fractures are hip, vertebral and wrist fractures. The hip fracture is the most serious as approximately half of these patients are unable to walk afterwards and one third become completely dependent. All this involves enormous treatment and nursing costs. The reasons for increased risk of fractures are numerous. Genetic as well as environmental factors are important as they intluence bone size, the number and thickness of trabeculae and cortical bone thickness. Peak bone mass depends of all of the stated. By remodelling the bone is maintaining its quality, optimal structure and microarhitectonics. With age the bone mass is lost due to the negative balance between the quantity of bone resorbed and newly formed. On the molecular and cellular level there is an interweaving of multiple factors guiding the development, differentiation and function of osteoclasts and osteoblasts - like in a well trained orchestra. In women, bone loss increases significantly in menopause because of estrogen insufficiency. In every basal multicellular unit, the balance between resorbtion and formation is negative. More women than men sustain osteoporotic fractures because the smaller skeleton incures greater structural damage and adapts less effectively by periostal bone formation. There is no equivalent midlife event in men and bone loss is relatively constant through aging because of the larger skeleton and greater accumulation of bone mass. Because of that, a critical level of bone mineral density is achieved much later than in women.
Descriptors		OSTEOPOROSIS FRACTURES, SPONTANEOUS OSTEOBLASTS OSTEOCLASTS BONE RESORPTION OSTEOGENESIS BONE MORPHOGENETIC PROTEINS BONE MATRIX BONE REMODELING BONE DENSITY