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Bone Loss and Osteoporosis: An Anthropological Perspective / Edition 1

Bone Loss and Osteoporosis: An Anthropological Perspective / Edition 1

by Sabrina C. Agarwal, Samuel D. Stout

ISBN-10: 030647767X

ISBN-13: 9780306477676

Pub. Date: 12/31/2003

Publisher: Springer US

With the growing incidence of fragility fractures in Europe and North America over the last three decades, bone loss and osteoporosis have become active areas of research in skeletal biology. Bone loss is associated with aging in both sexes and is accelerated in women with the onset of menopause. However, bone loss is related to a suite of complex and often


With the growing incidence of fragility fractures in Europe and North America over the last three decades, bone loss and osteoporosis have become active areas of research in skeletal biology. Bone loss is associated with aging in both sexes and is accelerated in women with the onset of menopause. However, bone loss is related to a suite of complex and often synergistically related factors including genetics, pathology, nutrition, mechanical usage, and lifestyle. It is not surprising that its incidence and severity vary among populations. Each chapter highlights the multifaceted nature of bone loss and fragility. Several underlying themes are common between the chapters, particularly the value of biocultural an evolutionary perspectives in the study of bone loss and fragility. The contributors come from a variety of fields, and this volume is intended for diverse audience including physical anthropologists, osteologists, bioengineers, and clinicians in sub-disciplines such as rheumatology, orthopedics, and general medicine.

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Springer US
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7.01(w) x 10.00(h) x 0.02(d)

Table of Contents

I. Current Concepts of Bone Loss and Osteoporosis.- Concepts of Bone Remodeling: A Unified Spatial and Temporal Model with Physiologic and Pathophysiologic Implications.- 1. Introduction.- 2. The Purposes of Bone Remodeling.- 2.1. The Basic Multicellular Unit as the Instrument of Bone Remodeling.- 3. Disordered Remodeling and Age Related Bone Loss.- References.- 2. On Changing Views about Age-Related Bone Loss.- 1. Introduction.- 1.1 On the Two Paradigms.- 1.1.1 The 1960 Paradigm.- 1.1.2 The Utah Paradigm.- 2. Age-Related Bone Loss.- 3. A Proposed Synthesis.- 4. Conclusions.- References.- 3. The Role of Bone Quality on Bone Loss and Fragility.- 1. Introduction.- 2. Determination of Bone Quality.- 3. Aging Changes in the Skeleton.- 4. The Problem of Diagenesis.- 5. Changes in Bone Mineralization with Diseases and Treatments.- 6. What Determines Skeletal Fragility?.- 7. Conclusions.- References.- II. Population Approaches.- 4. Ethnic Differences in Bone Mass and Architecture.- 1. Introduction.- 1.1. Osteoporosis.- 1.2. Bone Densitometry and Assessment of Bone Architecture.- 1.3. Bone Density and Fracture Incidence.- 1.4. Use of “Race” and “Ethnicity” in Biomedical Literature on Osteoporosis.- 2. Bone Mass and Bone Density.- 2.1. Definitions of Bone Density.- 2.2. Ethnic Differences in Bone Density.- 3. Bone Quality and Bone Turnover.- 4. Factors Affecting Bone Mass and Bone Loss.- 4.1. Adjusting Bone Density for Body Size.- 4.2. Body Size and Composition, and Preservation of the Skeleton.- 4.3. Calcium Nutrition.- 4.4. Physical Activity.- 5. Bone Geometry.- 5.1. Hip Axis Length.- 5.2. Cross-Sectional Geometry.- 6. Fracture Incidence.- 7. Summary.- References.- 5. Bone Loss, Fracture Histories, and Body Composition Characteristics of Older Males.- 1. Background.- 1.1. Definition of Terms.- 1.2. Bone Loss in Other Primates.- 1.3. Population Differences.- 2. Risk Factors.- 2.1. Factors Influencing Bone Turnover.- 2.2. Peak Bone Mass.- 2.3. Endocrinological Factors.- 2.4. Vitamin D and Vitamin D Receptors.- 2.5. Body Composition and Mechanical Factors.- 3. The Sun City/Tucson Longitudinal Study.- 3.1. Objectives.- 3.2. Subjects.- 3.3. Methods.- 3.4. Results.- 4. Discussion.- 4.1. Observed Bone Loss.- 4.2. Changes in Body Composition.- 4.3. Nutrition, Bone Density, and Prostate Cancer.- 5. Summary and Conclusions.- References.- 6. The Histomorphometry of the Subadult Rib: Age-Associated Changes in Bone Mass and the Creation of Peak Bone Mass.- 1. Introduction.- 1.1. Intracortical Bone Remodeling in the Subadult Rib.- 1.2. Peak Bone Mass and Age-Associated Bone Loss.- 1.3. Factors Determining Peak Bone Mass.- 2. A Study of Subadult Rib Histomorphometry.- 2.1. Cross-Sectional Areas and Bone Mass.- 2.1. Intracortical Remodeling: Osteon Population Density and Osteon Size.- 3. Summary and Conclusions.- References.- III. Evolutionary Perspectives.- 7. An Evolutionary and Biocultural Approach to Understanding the Effects of Reproductive Factors on the Female Skeleton.- 1. Introduction.- 2. Pregnancy.- 3. Parity.- 4. Lactation.- 5. Animal Models.- 6. Evolutionary and Historical Evidence.- 7. Discussion.- 8. Conclusions.- References.- 8. Functional Adaptation and Fragility of the Skeleton.- 1. Introduction.- 2. Mechanisms of Functional Adaptation.- 2.1. Effector Cells.- 2.2. Sensor Cells.- 2.3. Strain and the Mechanostat.- 2.4. The Two Poles of Adaptation.- 2.4.1. Disuse: Subnormal Loading.- 2.4.2. Overuse: Supernormal Loading.- 3. Skeletal Maintenance.- 3.1. Fatigue Damage Activates Remodeling.- 3.2. Remodeling Reduces Skeletal Weight.- 3.3. Responsive vs. Permissive Remodeling.- 3.4. The Volume Effect on Strength and Fatigue Life.- 3.5. Somatic vs. Evolutionary Adaptation.- 4. Skeletal Fragility.- 4.1. The Mechanostat and Sexual Dimorphism.- 4.2. Mechanical Priorities in Male and Female Bones.- 4.3. Estrogen and the Mechanostat Set Point.- 4.4. Menopause, the Set Point, and Postmenopausal Fragility.- 5. Summary.- Acknowledgments.- References.- 9. Effects of Vitamin D on Bone and Natural Selection of Skin Color: How Much Vitamin D Nutrition are We Talking About?.- 1. Introduction.- 2. Skin and Vitamin D Uptake.- 2.1. Metabolism of Vitamin D.- 3. What is Lack of Vitamin D?.- 4. “Normal” Requirements for Calcium and Vitamin D.- 5. Fur-Bearing Primates Obtain Vitamin D by Mouth.- 6. Vitamin D Deficiency Affecting Genetic Selection for Lighter Skin Color.- 7. Nutritional Implications of Vitamin D in Human Biology.- References.- IV. Bone Loss and Osteoporosis in Past Populations.- 10. Techniques for the Investigation of Age-Related Bone Loss and Osteoporosis in Archaeological Bone.- 1. Introduction.- 1.1. Background.- 1.2. Problems with Diagenetic Change.- 2. Visual Examination of Complete Bones.- 3. Investigations of Cortical Bone.- 3.1. Metacarpal Radiogrammetry.- 3.2. Cortical Histomorphometry.- 4. Investigations of Trabecular Bone.- 4.1. Visual Examination of Trabecular Bone Structure.- 4.2. Singh Index.- 4.3. Image Analysis of Trabecular Architecture.- 4.4. Stereometry.- 4.5. Energy Dispersive Low Angle X-Ray Scattering (EDLAXS).- 5. Investigative Techniques that Measure Whole Bone.- 5.1. Optical/Photo Densitometry.- 5.2. Dual Energy X-Ray Absorptiometry (DEXA).- 6. Conclusions.- References.- 11. Differentail Diagnoses of Intravitam and Postmortem Bone Loss at the Micro-Level.- 1. Introduction.- 2. Methods and Techniques Used in Histological Research of Macerated Bone Specimens.- 3. Intravitam Changes.- 3.1. Primary Osteoporosis.- 3.1.1. Idiopathic Osteoporosis.- 3.1.2. Postmenopausal Osteoporosis.- 3.1.3. Senile Osteoporosis.- 3.2. Secondary Osteoporosis.- 3.2.1. Osteoporosis due to Inactivity and Immobilization.- 3.2.2. Bone Loss Caused by Inflammatory Processes.- 3.2.3. Bone Loss Caused by Tumorous Processes.- 4. Causes of Postmortem Bone Loss.- 4.1. Soil and water.- 4.2. Plant Roots.- 4.3. Fungi, Algae, Bacteria, and Protozoa.- 4.4. Arthropods and their larvae.- 5. Conclusions and Summary.- Acknowledgments.- References.- 12. Histomorphology, Geometry, and Mechanical Loading in Past Populations.- 1. Introduction.- 2. Mechanobiology Methods for Preserved Skeletal Remains.- 2.1. Interpreting Preserved Evidence of Mechanical Loading History from Bone Geometry.- 2.2. Bone Microstructure and Mechanical Loading History.- 3. Application of Geometric and Histologie Biomechanical Approaches to Past Populations: The Palomans.- 3.1. Skeletal Sample.- 3.2. Methods and Findings.- 3.3. Changes through Time at Paloma.- 4. Conclusions.- References.- 13. Bone Remodeling and Age-Associated Bone Loss in the Past: A Histomorphometric Analysis of the Imperial Roman Skeletal Population of Isola Sacra.- 1. Introduction.- 2. Principles and Methodology of Bone Histomorphometry.- 2.1. Cortical Bone Sample Preparation.- 2.2. An Algorithm for Estimating Bone Remodeling rates in Ancient Skeletal Samples.- 2.3. Diagenesis.- 2.4. Age-at-Death.- 3. Previous Applications of Histomorphology in Past Populations.- 3.1. African Populations.- 3.2. European Populations.- 3.3. Native American Populations.- 3.4. Other Populations.- 4. Present Study: An Example in Histomorphology and Bioarchaeology.- 4.1. Materials.- 4.2. Methods.- 4.3. Results.- 4.3.1. Cortical Area in Isola Sacra.- 4.3.2. Bone Remodeling in Isola Sacra.- 4.3.3. Comparison of Isola Sacra with Modern samples.- 4.4. Age Associated Bone Loss in the Imperial Romans.- 5. Future Directions.- Acknowledgments.- References.

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