Is Osteoporosis Curable? Insights of the Utah Paradigm of Skeletal Physiology In 1999

摘要

This text summarizes things that would concern most absorptiometrists, clinicians, basic scientists and pharmaceutical companies involved in soem way with "osteoporosis". Currently available agents do not completely prevent or cure them, so a need persists for agents that do. The multidisciplinary Utah paradigm of skeletal physiology begins to change earlier ideas about the nature, causes and pathogenesis of "osteoporosis", and how to diagnose and manage them. Salient facts in that paradigm include: A) Muscle strength dominates the control of bone strength and "mass". B) It does so by causing the bone strains that directly or indirectly control the modeling and remodeling mechanisms that establish bone strength and "mass". C) Special strain thresholds, a posited mediator mechanism in marrow, and a posited mechanostat, all help to control how, where and when those things affect bone strength and "mass". D) Most nonmechanical agents (hormones, vitamin D, calcium, etc) can modulate but not duplicate those effects. E) At present indices of whole-bone strength obtained by peripheral quantitative computed tomography provide better noninvasive estimates than other methods.