The Utah Paradigm, Bone, and Osteoporosis. A 1999 Overview

摘要

A) The still evolving Utah paradigm of skeletal physiology adds new ideas about the postnatal control of bone strength and "mass" in health and disease, on earth and in orbit, and in "osteoporosis". B) In tis view neuromuscular function and anatomy dominate control of the biologic mechanisms that control postnatal bone strength and "mass"; most nonmechanical agents could only help or hinder but not duplicate that control. C) That contrasts with long-held views of a 1960 paradigm that regulation of existing osteoblasts and osteoclasts by nonmechanical agents dominates control of bone strength and "mass", and that mechanical influences have little effect on those properties. D) The new paradigm suggests new kinds of osteoporoses, new criteria for diagnosing them, and new directions for their study, prevention and management. It also questions some former ideas about their pathogenesis, pathophysiology and management, so controversies arise that time and others must resolve. The controversies involve some matters that are crucial for success so they need resolution, burt this article does not try to resolved them. Instead it suggests some issues they could concern.