Disuse osteoporosis: A better understanding of pathophysiology may lead to potential therapies
Journal Title: Journal of Diabetology and Endocrinology - Year 2016, Vol 1, Issue 1
Abstract
Amputation results in mechanical unloading of a previously weight bearing limb with subsequent focal decrease in bone mineral density (BMD), and the development of disuse osteoporosis. We report the case of a 44-year-old woman with a right above knee amputation sustained three decades ago, who was subsequently diagnosed with severe osteoporosis in the right proximal femur. We discuss the relative failure of established antiresorptive therapies to improve BMD above the site of the amputation, and the possibility that the underlying pathophysiology of disuse osteoporosis is different from osteoporosis associated with aging and menopause. A review of current literature suggests that an alteration in the secretion of sclerostin and parathyroid hormone (PTH) during mechanical unloading may be partially responsible for the development of disuse osteoporosis. Specific anabolic agents such as monoclonal antibody to sclerostin or recombinant PTH may be more effective than antiresorptive therapies to improve BMD and reduce fracture risk in patients with disuse osteoporosis.
Authors and Affiliations
Milsom S, Lin SY, Cornish J, Sharma S
Keywords
Related Articles
- EP ID EP556251
- DOI 10.14312/2398-0281.2016-1
- Views 39
- Downloads 0
Metformin in type 2 diabetes: where is the evidence?
Taking into consideration the main evidence available in 2015, Boussageon contest the status of metformin as the first -line treatment for DT2 patients. He contends that as regards macrovascular and microvascular complic...
Long-term correction of diabetic hyperglycemia through glucose-responsive hepatic insulin production using lentivirus
Type 1 diabetes mellitus (T1DM) is caused by the autoimmune destruction of the insulin-producing β cells of the pancreas. Insulin gene therapy is a promising strategy capable of overcoming the limitations of current trea...
Protocol of the DiaDec-study: Quality of life, health care utilisation and costs in patients with diabetes: The role of depression
Diabetes is a highly prevalent chronic disease with a substantial impact on quality of life and societal cost. Depressive disorders have been found to be more prevalent among individuals with diabetes than those without...
A comparative analysis of pharmacists' self-confidence beliefs for regular U-500 (concentrated) insulin and U-100 insulin
The purpose of this research was to assess pharmacist confidence levels in the accurate and safe counseling on Humulin R regular U-500 (concentrated) insulin compared to U-100 insulin. The investigators developed a 34-it...
Disuse osteoporosis: A better understanding of pathophysiology may lead to potential therapies
Amputation results in mechanical unloading of a previously weight bearing limb with subsequent focal decrease in bone mineral density (BMD), and the development of disuse osteoporosis. We report the case of a 44-year-old...