骨粗鬆症の成因と病態

Osteoporosis is a multifactorial disease characterized by low bone mineral density (BMD) and disorganized bone microarchitecture with increased probability for fratures. Substantial evidence obtained from gentic, biochemical and epidemiological analyses has identified a great number of genetic or environmental risk factors for osteoporosis. Identification of genetically high-risk patients and elimination of environmental risks is clinically important for prevention and treatment of osteoporosis especially from an economical point of view.
Osteoporosis is also multifactorial and complex in terms of pathophysiology, which often complicates its treatment. The disease is currently classified into two categories : primary osteoporosis including postmenopausal and senile osteoporosis ; and secondary osteoporosis caused by various diseases such as endocrinological, nutritional and metabolic disorders. Understanding of the pathophysiology of osteoporosis is critical to effective treatment. Deveopment of metabolic markers has enabled us to routinely analyze turnover of bone which is subject to continuous remodeling and to predict bone mass changes in the future.
This review focuses on the recent progress in understanding of the pathogenesis and the pathophysiology of osteoporosis.