Osteoporosis - Causes, Symptoms, Diagnosis, Treatment

Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases**. This can lead to a decrease in bone strength that can increase the risk of fractures.**
In order to learn how the bone mass decreases, we first need to learn the bone remodeling process.
Bone remodeling is a process that ensures the continuous regeneration of bone tissue. Now the bone remodeling has two steps: bone resorption, when specialized cells called osteoclasts break down bone, and bone formation, which is when another type of cells called osteoblasts form new bone. Normally, there is a balance between bone resorption and bone formation. However, in some cases, this balance is disturbed and bone resorption becomes more than bone formation. And the fact that bone resorption is more than bone formation causes a decrease in bone mass. And this can result in osteoporosis.
So what are the conditions that cause bone resorption to be more than bone formation?
Now as we know, there are osteoblasts in our bones. And osteoblasts are the cells that form new bone. But osteoblasts from older individuals have reduced proliferative and biosynthetic potential and reduced response to growth factors compared to osteoblasts in younger individuals. And thus, the bone formation capacity decreases. And since bone resorption becomes more than bone formation, bone mass decreases and osteoporosis occurs. This form of osteoporosis known as senile osteoporosis. And senile means depending on old age.
And the second cause is reduced physical activity. Physical activity or exercises increase mechanical forces on bones, consequently initiates bone formation and increases bone mass. Therefore, bone formation is less in people with less physical activity. And this causes less bone mass and osteoporosis formation.
Glucocorticoid use is another important cause of osteoporosis. Normally, glucocorticoids have immunosuppressive properties. That's why glucocorticoids are used in diseases where the immune system overreacts, such as asthma, multiple sclerosis, and allergies. However, the use of glucocorticoid causes a
decrease in the number of osteoblasts, which are bone-forming cells. Thus, the number of osteoclasts, which are bone resorbing cells, exceeds the number of osteoblasts, which are bone-forming cells. And thus, bone mass decreases and osteoporosis occurs.

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