Bone Health and the Environment. Bone Functions Calcium HomeostasisCalcium Homeostasis –Calcium “bank” Skeletal IntegritySkeletal Integrity –Muscle –Nerve.

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Presentation transcript:

Bone Health and the Environment

Bone Functions Calcium HomeostasisCalcium Homeostasis –Calcium “bank” Skeletal IntegritySkeletal Integrity –Muscle –Nerve –endocrine

The Scientific Basis of Orthopaedics, Albright, James; Brand, Richard

Calcium Hydroxyapatite

The Scientific Basis of Orthopaedics, Albright, J; Brand, R.

Hydroxyapatite: a-axis projection of the crystal structure. The Scientific Basis of Orthopaedics, Albright, J; Brand,R.

A single crystal of hydroxyapatite Ca 5 (PO 4 ) 3 (OH) synthesized at 400°C and 2 kbar water pressure with a size of approximately 1 x 0.05 mm. The Scientific Basis of Orthopaedics, Albright, J; Brand, R.

STAGES OF BONE GROWTH AND LOSS Age in Years Active Growth Slow Loss Rapid Loss Less Rapid Loss

2nd Decade of Life 5th Decade of Life 8th Decade of Life The Scientific Basis of Orthopaedics, Albright, J; Brand, R.

Determinants of Peak Bone Mass Genetic Influence Diet Exercise and activity Hormone Status

Genetic Influence

Relation of Alleles of the Collagen Type Ia1 Gene to Bone Density and the Risk of Osteoporotic Fractures in Postmenopausal Women André G. Uitterlinden, et al. Volume 338: April 9, 1998Number 15

Calcium Requirement Age Group( years)Calcium mg/day Youth (0-11) Young Adult (11-25)1200 Adult (25-50)1000 Post -menopausal1500

Modulators of Intestinal calcium absorption Increase Vit D Low Ca++ diet High Na+ diet PTH Phosphate depletion GH Estrogen Pregnancy Lactation Furosemide Decrease Aging High Ca++ diet Low Na+ diet Glucocorticoids Phosphate loading Thyroid Hormone Metabolic Acidosis Thiazides

Bone Loss Following Discontinuation of HRT Post-HRT Bone Loss (n=50) Postmenopausal Bone Loss (n=81)post Mean % Change ± SD from Baseline Number of Years Following Estrogen Cessation Trémollieres FA, et al. Osteoporosis Int. 2001;12:385–390. 0–2 years3–5 years6–8 years

Placebo-Treated Postmenopausal Women Rapidly Lose Microarchitectural Elements Baseline1 Year Dufrense, et al. OI 2002 World Congress on Osteoporosis

Exercise and Activity

Calcaneal BMD vs WHO Norms Weight Lifters Swimmers WHO Norms Groups Areal BMD

The Scientific Basis of Orthopaedics, Albright, J; Brand, Richard

Bone Bank Mechanical Usage Effects on Bone Architecture The Scientific Basis of Orthopaedics, Albright, J; Brand, R.

Thank You