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Bone Health and the Environment

Bone Health and the Environment. Bone Functions. Calcium Homeostasis Calcium “bank” Skeletal Integrity Muscle Nerve endocrine. The Scientific Basis of Orthopaedics , Albright, James; Brand, Richard. Calcium Hydroxyapatite. The Scientific Basis of Orthopaedics , Albright, J; Brand, R.

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Bone Health and the Environment

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  1. Bone Health and the Environment

  2. Bone Functions • Calcium Homeostasis • Calcium “bank” • Skeletal Integrity • Muscle • Nerve • endocrine

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

  4. Calcium Hydroxyapatite

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

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

  7. A single crystal of hydroxyapatite Ca5(PO4)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.

  8. STAGES OF BONE GROWTH AND LOSS Active Growth Slow Loss Rapid Loss Less Rapid Loss 10 20 30 40 50 60 70 80 90 Age in Years

  9. 2nd Decade of Life 5th Decade of Life 8th Decade of Life The Scientific Basis of Orthopaedics, Albright, J; Brand, R.

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

  11. Genetic Influence

  12. Volume 338:1016-1021 April 9, 1998 Number 15 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.

  13. Calcium Requirement

  14. 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 Modulators of Intestinal calcium absorption

  15. Bone Loss Following Discontinuation of HRT Number of Years Following Estrogen Cessation 1.0 0–2 years 3–5 years 6–8 years 0.5 0.0 -0.5 -1.0 Mean % Change ± SD from Baseline -1.5 -2.0 -2.5 Post-HRT Bone Loss (n=50) -3.0 Postmenopausal Bone Loss (n=81)post -3.5 Trémollieres FA, et al. Osteoporosis Int. 2001;12:385–390.

  16. Placebo-Treated Postmenopausal Women Rapidly Lose Microarchitectural Elements Baseline 1 Year Dufrense, et al. OI 2002 World Congress on Osteoporosis

  17. Exercise and Activity

  18. 0.8 0.530 0.500 0.436 0.4 Areal BMD 0 Weight Lifters Swimmers WHO Norms Groups Calcaneal BMD vs WHO Norms

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

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

  21. Thank You

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