Bone modeling and remodeling Bone modeling Child and

1
?????
2
??????????


?????
????
??????
???????
????
????
?????????
?????????
????
3
Bone modeling and remodeling

• Bone modeling
• Child and adolescent
• Non-coupling bone formation and resorption
  occur on separate surfaces
• Bone remodeling
• The replacement of old bone tissue by new bone
  tissue in the adult skeleton
• Coupling

4
(No Transcript)
5
Osteoporosis ? imbalance in bone remodeling
Results in thinning and eventual loss of
trabecular connectivity
6
Definition of Osteoporosis
Osteoporosis is defined as a skeletal disorder
characterized by compromised bone strength
predisposing a person to an increased risk of
fracture. Bone strength primarily reflects the
integration of bone density and bone quality. NIH
Consensus Conference
Normal bone
Osteoporosis
NIH Consensus Development Panel on Osteoporosis.
JAMA 285785-95, 2001
7
Osteoporosis

• Primary prevention
• Should provided all the people as comprehensive
  measures against other lifestyle-related diseases
• Secondary prevention
• Should target people at higher risk of
  osteoporotic fractures
• Tertiary prevention
• Should be provided the patients and at frail
  elderly people using medical or long-term care
  insurance

• Primary osteoporosis
• Older persons and women past menopause in which
  bone loss is accelerated over that predicted for
  age and sex.
• Secondary osteoporosis
• Metabolic bone disease
• hyperparathyroidism
• Neoplasia
• multiple myeloma or metastatic carcinoma
• Malnutrition
• Drug therapy
• with corticosteroids
• Prolonged immobilization
• Weightlessness with space travel

Osteoporosis Tutorial
8
???X???????
????
9
(No Transcript)
10
(No Transcript)
11
Factors affecting bone metabolism
12
Medical treatment for osteoporosis

• Anti-resorptive agent
• Estrogen
• SERM
• Raloxifene (Evista)
• Calcitonin
• Bisphosphonate
• Alendronate (Fosamax)
• Risedronate (Actonel)
• Ibandronate (Bonviva)
• ( Bone resorption)

• Anabolic agent
• PTH (cyclic use)
• ( Bone formation)
• Strontium ranelate
• ( Bone formation)
• ( Bone resorption)

13
(No Transcript)
14
Protos
OPG
15
NEJM 2004350459-468
16
AEs of strontium ranelate (Protos)

• 2g of strontuim ranelate mix with a glass of
  water and drink immediately.
• Taken before bedtime or 2-h before/after the meals

16
17
Thank you for your attention!