Acquired disturbance of the skeletal system Osteoporosis and rickets/osteomalacia

作者：Pozza S Bechtold Dalla^*

来源：Osteologie, 2013, 22(2): 108-112.

• Osteoporosis
• rickets
• osteomalacia
• glucocorticoids
• cytokines

Osteoporosis is a well-known worldwide health problem. Usually adults, especially the elderly, are affected. However, children could also develop osteoporosis or less severe forms of reduced bone mass. The underlying pathomechanism is multifactorial. Several candidate genes have been found being associated with lower bone mineral density. Besides primary osteoporosis forms a large number of chronic diseases are accompanied by bone loss. The child may not reach his or her genetically-determined peak bone mass or develop fractures. The mechanism involved in the pathogenesis of secondary bone loss includes among others elevated cytokines influencing the balance between modelling and remodelling. Glucocorticoid induced osteoporosis is the most common form of secondary osteoporosis. Glucocorticoids have direct and indirect effects on the skeleton. They impair the replication, differentiation and function of osteoblasts and induce apoptosis of mature osteoblasts and osteocytes, leading to suppression of bone formation. Glucocorticoids promote osteoclastogenesis and therefore increase bone resorption. Besides disease related bone loss, lifestyle changes including food and amount of weight bearing activity have an influence, on bone health. Due to a survey in Germany, about 60 % of children and adolescents have insufficient vitamin D levels leading possibly to rickets or osteomalacia, especially those with a migration background. Early recognition as well as preventive and therapeutic strategies are warranted to provide bone health in children.

• 出版日期2013