Volume 140, Issue 1, Pages 22-25 (January 2011) The Impact of Gastrointestinal and Liver Diseases on Bone: It Ain't Like Menopause!  Francisco A. Sylvester  Gastroenterology  Volume 140, Issue 1, Pages 22-25 (January 2011) DOI: 10.1053/j.gastro.2010.11.024 Copyright © 2011 AGA Institute Terms and Conditions

Figure 1 The integrity of the adult skeleton depends on the coupling of bone formation and bone resorption. In the steady state, osteoblasts replace bone eroded by osteoclasts in response to damage, mechanical strain, or metabolic demand for calcium, resulting in maintenance of bone mass and architecture (A). In postmenopausal bone loss, both osteoblasts and osteoclasts become more active. However, bone formation falls behind bone resorption, with a consequent reduction in bone mass. Over time, bone architectural elements are lost, which affects structure and increases the risk of fracture (B). In gastrointestinal and liver disorders, bone formation is attenuated and does not keep up with normal bone resorption, resulting in a net loss of bone mass. Whether the loss of bone mass in digestive and cholestatic disorders increases the risk of fractures requires further investigation (C). Gastroenterology 2011 140, 22-25DOI: (10.1053/j.gastro.2010.11.024) Copyright © 2011 AGA Institute Terms and Conditions