Secondary Osteoporosis: The Potential Relevance of Leptin and Low Body Weight

Editorials21 November 2000Secondary Osteoporosis: The Potential Relevance of Leptin and Low Body WeightGregory R. Mundy, MDGregory R. Mundy, MDDr. Mundy: University of Texas Health Science Center; San Antonio, TX 78284-7877Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-10-200011210-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The diagnosis and treatment of osteoporosis have advanced greatly in the past 20 years. We now have effective (albeit imperfect) drugs, such as bisphosphonates, estrogen, and selective estrogen-receptor modulators, that substantially reduce fracture rates. Selective estrogen-receptor modulators may provide other benefits, such as alleviation of breast cancer risk. Because the techniques for assessment of bone mass and subsequent prediction of risk for fracture have improved, it is easier to make treatment decisions and to diagnose osteoporosis before fractures occur. This improvement in management is likely to continue during the next decade. By then, anabolic agents will be available to stimulate ...References1. Suda T, Takahashi N, Udagawa N, Jimi E, Gillespie MT, Martin TJ. Modulation of osteoclast differentiation and function by the new members of the tumor necrosis factor receptor and ligand families. Endocr Rev. 1999;20:345-57. CrossrefMedlineGoogle Scholar2. Grinspoon S, Thomas E, Pitts S, Gross E, Mickley D, Miller K, et al . Prevalence and predictive factors for regional osteopenia in women with anorexia nervosa. Ann Intern Med. 2000;133:790-4. LinkGoogle Scholar3. Bernstein CN, Blanchard JF, Leslie W, Wajda A, Yu BN. The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study. Ann Intern Med. 2000;133:795-9. LinkGoogle Scholar4. Grinspoon S, Miller K, Coyle C, Krempin J, Armstrong C, Pitts S, et al . Severity of osteopenia in estrogen-deficient women with anorexia nervosa and hypothalamic amenorrhea. J Clin Endocrinol Metab. 1999;84:2049-55. MedlineGoogle Scholar5. Hotta M, Fukuda I, Sato K, Hizuka N, Shibasaki T, Takano K. The relationship between bone turnover and body weight, serum insulin-like growth factor (IGF) I, and serum IGF-binding protein levels in patients with anorexia nervosa. J Clin Endocrinol Metab. 2000;85:200-6. MedlineGoogle Scholar6. Soyka LA, Grinspoon S, Levitsky LL, Herzog DB, Klibanski A. The effects of anorexia nervosa on bone metabolism in female adolescents. J Clin Endocrinol Metab. 1999;84:4489-96. MedlineGoogle Scholar7. Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res. 1993;8:567-73. CrossrefMedlineGoogle Scholar8. Tremollieres FA, Pouilles JM, Ribot C. Vertebral postmenopausal bone loss is reduced in overweight women: a longitudinal study in 155 early postmenopausal women. J Clin Endocrinol Metab. 1993;77:683-6. MedlineGoogle Scholar9. Ravn P, Cizza G, Bjarnason NH, Thompson D, Daley M, Wasnich RD, et al . Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group. J Bone Miner Res. 1999;14:1622-7. CrossrefMedlineGoogle Scholar10. Ducy P, Amling M, Takeda S, Priemel M, Schilling AF, Beil FT, et al . Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell. 2000;100:197-207. CrossrefMedlineGoogle Scholar11. Martin RB, Chow BD, Lucas PA. Bone marrow fat content in relation to bone remodeling and serum chemistry in intact and ovariectomized dogs. Calcif Tissue Int. 1990;46:189-94. CrossrefMedlineGoogle Scholar12. Meunier P, Aaron J, Edouard C, Vignon G. Osteoporosis and the replacement of cell populations of the marrow by adipose tissue. A quantitative study of 84 iliac bone biopsies. Clin Orthop. 1971;80:147-54. CrossrefMedlineGoogle Scholar13. Chen D, Ji X, Harris MA, Feng JQ, Karsenty G, Celeste AJ, et al . Differential roles for bone morphogenetic protein (BMP) receptor type IB and IA in differentiation and specification of mesenchymal precursor cells to osteoblast and adipocyte lineages. J Cell Biol. 1998;142:295-305. CrossrefMedlineGoogle Scholar14. Karsenty G. The genetic transformation of bone biology. Genes Dev. 1999;13:3037-51. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gregory R. Mundy, MDAffiliations: Dr. Mundy: University of Texas Health Science Center; San Antonio, TX 78284-7877Corresponding Author: Gregory R. Mundy, MD, Endocrinology and Metabolism, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284-7877. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevalence and Predictive Factors for Regional Osteopenia in Women with Anorexia Nervosa Steven Grinspoon , Elizabeth Thomas , Sarah Pitts , Erin Gross , Diane Mickley , Karen Miller , David Herzog , and Anne Klibanski The Incidence of Fracture among Patients with Inflammatory Bowel Disease: A Population-Based Cohort Study Charles N. Bernstein , James F. Blanchard , William Leslie , Andre Wajda , and B. Nancy Yu Regional Osteoporosis in Anorexia Nervosa Philip S. Mehler Metrics Cited byVery high bone mineral density in a monogenic form of obesity-associated insulin resistanceThe Physiology of Anorexia Nervosa and Bulimia NervosaThe Physiology of Anorexia NervosaBone health across the generations: a primer for health providers concerned with osteoporosis preventionRisk of bone loss in men with multiple sclerosisAnorexia Nervosa Medical IssuesOsteoporosis in anorexia nervosa: Prevention and treatmentRole of leptin and leptin receptor in inflammationOsteoporosis: Prevention and treatment in anorexia nervosaRegional Osteoporosis in Anorexia NervosaPhilip S. Mehler, MDRegional Osteoporosis in Anorexia NervosaSteven Grinspoon, MD and Anne Klibanski, MDUpdate in EndocrinologyLeonard Wartofsky, MDAll Patients with Inflammatory Bowel Disease Should Have Bone Density Assessment: Con 21 November 2000Volume 133, Issue 10Page: 828-830KeywordsAdipocytesAnorexia nervosaBody weightBoneBone remodelingBone resorptionEstrogensInflammatory bowel diseaseLeptinOsteoporosis ePublished: 21 November 2000 Issue Published: 21 November 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...