Secondary osteoporosis: Pathophysiology &amp; diagnosis

Emkey, Gregory R.; Epstein, Sol

doi:10.1016/j.beem.2014.07.002

Cited by 56 publications

(31 citation statements)

References 238 publications

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“…Indeed, anti-resorptives such as bisphosphonates, exercise regimens that mechanically load the skeleton, and nutritional supplementation countermeasures to prevent bone loss in space are still not fully effective, suggesting the existence of additional factors causing bone loss in weightlessness conditions [37][38][39][40][41]. What is especially interesting is that aged individuals and astronauts have at least three pathophysiological changes in common: a dysfunction of the vestibular system [42, 43•], an increase in SNS activity [44][45][46], and bone loss [42,47]. The observations that vestibular dysfunction alter sympathetic outflow and that sympathetic nerve activity regulates bone remodeling begged the question as to whether the vestibular system had an influence on bone homeostasis.…”

Section: Bone Homeostasis Regulation By the Sympathetic Nervous Systemmentioning

confidence: 99%

The Vestibular System: A Newly Identified Regulator of Bone Homeostasis Acting Through the Sympathetic Nervous System

Vignaux

Besnard

Denise

et al. 2015

Curr Osteoporos Rep

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The vestibular system is a small bilateral structure located in the inner ear, known as the organ of balance and spatial orientation. It senses head orientation and motion, as well as body motion in the three dimensions of our environment. It is also involved in non-motor functions such as postural control of blood pressure. These regulations are mediated via anatomical projections from vestibular nuclei to brainstem autonomic centers and are involved in the maintenance of cardiovascular function via sympathetic nerves. Age-associated dysfunction of the vestibular organ contributes to an increased incidence of falls, whereas muscle atrophy, reduced physical activity, cellular aging, and gonadal deficiency contribute to bone loss. Recent studies in rodents suggest that vestibular dysfunction might also alter bone remodeling and mass more directly, by affecting the outflow of sympathetic nervous signals to the skeleton and other tissues. This review will summarize the findings supporting the influence of vestibular signals on bone homeostasis, and the potential clinical relevance of these findings.

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Section: Bone Homeostasis Regulation By the Sympathetic Nervous Systemmentioning

confidence: 99%

The Vestibular System: A Newly Identified Regulator of Bone Homeostasis Acting Through the Sympathetic Nervous System

Vignaux

Besnard

Denise

et al. 2015

Curr Osteoporos Rep

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“…A 63-year-old MM patient receiving bortezomib suffered frequent musculoskeletal pains and falls, and the tests revealed osteomalacia with a very low blood vit D level at 20nmol/L. The symptoms recovered markedly within 4 months with vit D replacement [10]. This indicates that vit D plays a major role in the musculoskeletal system pains in MM patients, and these symptoms could resolve with vit D replacement.…”

Section: Discussionmentioning

confidence: 73%

“…Osteoporosis is a skeletal system disease where the bone mass decreases and there are changes in the microstructure causing a tendency to fracture. The reason is usually aging, the menopause and steroid use [10]. Osteomalacia is usually together with osteoporosis in later years.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Deficiency and its Effects on Patients with Multiple Myeloma

Gedık¹

2017

HTIJ

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Objective: It was aimed to evaluate Vitamin D deficiency and its relationship with chemotherapies, autologous stem cell transplantation, bone density, and fractures in patients with MM in this study. Patients and Method:In this retrospective study, patients who were diagnosed with MM and followed up at the hematology department between June 2014 and December 2014 were evaluated in terms of vit-D level in the blood, retrospectively.Results: Of 31 patients with MM, 19 cases were male. The median age was 63 (Range: 49-90 years). The mean vit-D level was 11.9±7.6ng/ml, and was low in 20 of 33 cases (93%). The vit D level was significantly lower in cases whom a greater number of chemotherapy cycles was administered (p= 0.033). There was no statistically significant relationship between blood vit D level and bone fracture development (p= 0.55), DEXA results (p= 0.703), International Staging System (ISS) stage, and whether ABMT had been performed or not (p= 0.752). Conclusion:Osteoporosis, osteonecrosis and fracture are more observed in MM patients in relation with low vit D level in the blood that is more common in advanced age and corticosteroid use.

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“…according to European statistics data, during 2010, femoral fractures were diagnosed in 620000 patients: 574000 individuals had fractures of forearm, 250000 -proximal humerus, and 620000 -fractures of the vertebrae, in both men and women of 50 years of age and older, with clinical osteoporosis as the major contributing factor. these injuries made 34.8% of all bone fractures registered [5,6]. Pelvic, costal and lower leg fractures were often osteoporotic in origin as well.…”

Section: Introductionmentioning

confidence: 99%