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• W2058776400 startingPage "441" @default.
• W2058776400 abstract "Over a decade ago, we proposed a unitary model for the pathogenesis of osteoporosis that identified estrogen deficiency as the predominant cause of both the early, accelerated, and late slow phases of bone loss in postmenopausal women and as a contributing cause of the continuous phase of bone loss in aging men. While this was a plausible model then, new data over the intervening years suggest a need to modify these concepts. Indeed, based largely on rodent studies, a revisionist view of the pathogenesis of osteoporosis has been proposed recently that attempts a paradigm shift from the estrogen-centric model to one in which bone loss is largely independent of estrogen deficiency and is driven instead by cell-autonomous age-related factors. However, detailed clinical investigative studies using quantitative computed tomography demonstrate that the onset of cortical bone loss in humans is closely tied to estrogen deficiency; thus the estrogen-centric view is likely correct for cortical bone, which comprises over 80% of the skeleton and is the major structural determinant of fracture risk at most skeletal sites. By contrast, these same studies also demonstrate that trabecular bone loss begins in sex hormone-replete young adults of both sexes. This suggests that a significant proportion of trabecular bone loss is either estrogen-independent or, as suggested by some studies, requires higher levels for its regulation. In this perspective, we critically review these and other findings, leading us to conclude that our original model requires modification but not revision." @default.
• W2058776400 created "2016-06-24" @default.
• W2058776400 creator A5015517215 @default.
• W2058776400 creator A5027073303 @default.
• W2058776400 creator A5090023242 @default.
• W2058776400 date "2011-02-18" @default.
• W2058776400 modified "2023-10-10" @default.
• W2058776400 title "The unitary model for estrogen deficiency and the pathogenesis of osteoporosis: Is a revision needed?" @default.
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• W2058776400 doi "https://doi.org/10.1002/jbmr.262" @default.
• W2058776400 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3179298" @default.

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