Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- 14 Consequences of alterations in bone remodeling
- 15 The role of parathyroid hormone and hyperparathyroidism in osteoporosis
- 16 Senile Osteoporosis
- Part IV Clinical aspects of osteoporosis
- Index
15 - The role of parathyroid hormone and hyperparathyroidism in osteoporosis
Published online by Cambridge University Press: 01 June 2011
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- 14 Consequences of alterations in bone remodeling
- 15 The role of parathyroid hormone and hyperparathyroidism in osteoporosis
- 16 Senile Osteoporosis
- Part IV Clinical aspects of osteoporosis
- Index
Summary
Introduction
Indirect evidence for a permissive role of parathyroid hormone in osteoporosis
Parathyroid hormone (PTH) is essential to maintain normal calcium homeostasis (Chapter 6), bone turnover (Chapter 14) and vitamin D metabolism (cf. Chapter 7) under physiological conditions. It also appears as a significant permissive factor in most pathological conditions associated with osteoporosis. This is best illustrated by the fact that patients who have developed hypoparathyroidism following thyroid or parathyroid surgery have increased bone density at the radius, lumbar spine and hip compared to similar surgical patients without hypoparathyroidism (Abugassa et al., 1993; Fujiyama et al., 1995; Seeman et al., 1982). Hypoparathyroidism also prevents rapid bone loss associated with menopause (Fujiyama et al., 1995) and bone loss in patients with risk factors for osteoporosis (Touliatos et al., 1995). Furthermore, parathyroidectomy can minimize bone loss induced by a low calcium diet (Burkhart & Jowsey, 1967) or immobilization (Jowsey & Raisz, 1968) in experimental animals. This chapter will thus review how PTH and factors affecting PTH concentration and/or biological effects are involved in the development of primary and secondary osteoporosis.
Role of parathyroid hormone in osteoporosis
Role of PTH in primary osteoporosis
Two main factors have been implicated in the genesis of primary osteoporosis, the estrogen deficiency of menopause (type I osteoporosis) and a multifactorial secondary hyperparathyroidism associated with aging (type II osteoporosis).
- Type
- Chapter
- Information
- The Osteoporosis Primer , pp. 211 - 224Publisher: Cambridge University PressPrint publication year: 2000