Senile osteoporosis

Senile osteoporosis, formerly known as osteoporosis type II, has been recently recognized as a geriatric syndrome with a particular pathophysiology.

It has been pointed out that senile osteoporosis is the product of a skeleton in an advanced stage of life and also due to a deficiency caused by calcium, but physicians are also coming to the conclusion that multiple mechanisms in the development stages of the disease interact together and the product is an osteoporotic bone, regardless of age.[1]

Cause

Most of the etiologic considerations regarding senile osteoporosis are not very clear for physicians yet. But based on the current evidence attached to clinical experimentation, it has been determined that the pathogenesis of the disease is clearly related to a deficiency of zinc. Such deficiency is known to lead to an increment of endogenous heparin, which is most likely caused by mast cell degranulation, and an increase in the bone resorption (calcium discharge in the bones) reaction of prostaglandin E2, which constrain the formation of more bone mass, making bones more fragile. These co-factors are shown to play an important role in the pathogenetic process attached to senile osteoporosis as they enhance the action of the parathyroid hormone.[2]

The intake of calcium in elder people is quite low, and this problem is worsened by a reduced capability to ingest it. This, attached to a decrease in the absorption of vitamin D concerning metabolism, are also factors that contributes to a diagnosis of osteoporosis type II.

Treatment

Even though more studies are necessary for an efficient evaluation of the role played by zinc in senile osteoporosis, doctors recommend a proper supplementation of dietary zinc.

Replacement estrogen has proved to be an efficient way to combat the loss of bone mass in women when such treatment is started in the menopausal stage of their lives. John R. Lee, a Harvard graduate who wrote a book on the subject, came to the conclusion that by adding supplementation with natural progesterone to an existing natural osteoporosis treatment program, bone density was increased every year by 3-5% until it stabilized at the bone density levels expected for a 35-year-old woman, this after studies in 100 women between 38 and 83 with an average of 62 years old.[3]

References

  1. ↑ An overview on Osteoarthritis MedicineNet. Retrieved on 2010-03-05
  2. ↑ National Center for Biotechnology Information. "Etiology of senile osteoporosis" 2010-03-05.
  3. ↑ Natural Progesterone And Osteoporosis Treatment Archived 2010-03-08 at the Wayback Machine. Retrieved on 2010-03-05

Further reading

  • The new Aging Bone Research Centre at Nepean Clinical School-University of Sydney
  • syndrome webpage
  • a video on the mechanisms of senile osteoporosis
  • Duque, Gustavo and Douglas P. Kiel, eds. (2008). Osteoporosis in Older Persons: Pathophysiology and Therapeutic Approach. Berlin: Springer. ISBN 978-1-84628-515-8. OCLC 166372389.
  • Demontiero, Oddom; Gustavo Duque (2009). "Once-yearly zoledronic acid in hip fracture prevention". Clinical Interventions in Aging. 4 (1): 153–64. doi:10.2147/cia.s5065. PMC 2685236. PMID 19503777.
  • Elbaz A; Wu X; Rivas D; Gimble JM; Duque G (March 2009). "Inhibition of fatty acid biosynthesis prevents adipocyte lipotoxicity on human osteoblasts in vitro". Journal of Cellular and Molecular Medicine. 14 (4): 982–91. doi:10.1111/j.1582-4934.2009.00751.x. PMC 2891630. PMID 19382912.
  • Gasparrini M; Rivas D; Elbaz A; Duque G (June 2009). "Differential expression of cytokines in subcutaneous and marrow fat of aging C57BL/6J mice". Experimental Gerontology. 44 (9): 613–8. doi:10.1016/j.exger.2009.05.009. PMID 19501151.
  • Elbaz A; Rivas D; Duque G (March 2009). "Effect of estrogens on bone marrow adipogenesis and Sirt1 in aging C57BL/6J mice". Biogerontology. 10 (6): 747–55. doi:10.1007/s10522-009-9221-7. PMID 19333775.
  • Duque G; Demontiero O; Troen BR (February 2009). "Prevention and treatment of senile osteoporosis and hip fractures". Minerva Medica. 100 (1): 79–94. PMID 19277006.
  • Duque G, Huang DC, Macoritto M, et al. (March 2009). "Autocrine regulation of interferon gamma in mesenchymal stem cells plays a role in early osteoblastogenesis". Stem Cells (Dayton, Ohio). 27 (3): 550–8. doi:10.1634/stemcells.2008-0886. PMID 19096039.
  • Duque G, Rivas D, Li W, et al. (March 2009). "Age-related bone loss in the LOU/c rat model of healthy ageing". Experimental Gerontology. 44 (3): 183–9. doi:10.1016/j.exger.2008.10.004. PMID 18992316.
  • Akter R; Rivas D; Geneau G; Drissi H; Duque G (February 2009). "Effect of lamin A/C knockdown on osteoblast differentiation and function". Journal of Bone and Mineral Research. 24 (2): 283–93. doi:10.1359/jbmr.081010. PMID 18847334.
  • Duque G (July 2008). "Bone and fat connection in aging bone". Current Opinion in Rheumatology. 20 (4): 429–34. doi:10.1097/BOR.0b013e3283025e9c. PMID 18525356.
  • Duque G; Troen BR (May 2008). "Understanding the mechanisms of senile osteoporosis: new facts for a major geriatric syndrome". Journal of the American Geriatrics Society. 56 (5): 935–41. doi:10.1111/j.1532-5415.2008.01764.x. PMID 18454751.
  • Duque G (2008). "Intravenous zoledronic acid reduced new clinical fractures and deaths in patients who had recent surgery for hip fracture". ACP Journal Club. 148 (2): 40. PMID 18311870.
  • Rivas D; Akter R; Duque G (2007). "Inhibition of Protein Farnesylation Arrests Adipogenesis and Affects PPAR Expression and Activation in Differentiating Mesenchymal Stem Cells". PPAR Research. 2007: 81654. doi:10.1155/2007/81654. PMC 2220071. PMID 18274630.
  • Duque G; Rivas D (October 2007). "Alendronate has an anabolic effect on bone through the differentiation of mesenchymal stem cells". Journal of Bone and Mineral Research. 22 (10): 1603–11. doi:10.1359/jbmr.070701. PMID 17605634.
  • Duque G, Mallet L, Roberts A, et al. (September 2006). "To treat or not to treat, that is the question: proceedings of the Quebec Symposium for the Treatment of Osteoporosis in Long-term Care Institutions, Saint-Hyacinthe, Quebec, November 5, 2004". Journal of the American Medical Directors Association. 7 (7): 435–41. doi:10.1016/j.jamda.2006.05.006. PMID 16979088.
  • Retornaz F; Duque G (October 2006). "[Osteoporosis in the elderly]". Presse Médicale (in French). 35 (10 Pt 2): 1547–56. doi:10.1016/S0755-4982(06)74850-3. PMID 17028520.
  • Duque G (2006). "Dietetic assistants improved postoperative clinical outcomes in older women with hip fracture". ACP Journal Club. 145 (2): 40. PMID 16944860.
  • Duque G; Rivas D (April 2006). "Age-related changes in lamin A/C expression in the osteoarticular system: laminopathies as a potential new aging mechanism". Mechanisms of Ageing and Development. 127 (4): 378–83. doi:10.1016/j.mad.2005.12.007. PMID 16445967.
  • Vecino-Vecino C; Gratton M; Kremer R; Rodriguez-Mañas L; Duque G (2006). "Seasonal variance in serum levels of vitamin d determines a compensatory response by parathyroid hormone: study in an ambulatory elderly population in Quebec". Gerontology. 52 (1): 33–9. doi:10.1159/000089823. PMID 16439822.
  • Montero-Odasso M; Schapira M; Duque G; Soriano ER; Kaplan R; Camera LA (2005). "Gait disorders are associated with non-cardiovascular falls in elderly people: a preliminary study". BMC Geriatrics. 5: 15. doi:10.1186/1471-2318-5-15. PMC 1325027. PMID 16321159.
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