FOREWORD -- TABLE OF CONTENTS -- CHAPTER 1 EPIDEMIOLOGY OF OSTEOPOROSIS -- Research agenda -- Summary -- Introduction -- Definition -- Predicting fracture risk -- Fracture epidemiology -- Hip fracture -- Vertebral fracture -- Distal forearm fracture -- Socio-economic impact of osteoporosis -- Mortality -- Morbidity and quality of life -- Costs of osteoporosis -- REFERENCES -- CHAPTER 2 THE SOCIAL AND FINANCIAL COSTS OF OSTEOPOROSIS -- 1. Nature of osteoporosis -- 2. Financial costs of osteoporosis -- 3. Social costs of osteoporosis -- 4. Screening program: BMD Vs Bone turnover markers -- 5. Public awareness and prevention of osteoporosis -- 6. Conclusion -- REFERENCES -- CHAPTER 3 PATHOGENESIS OF OSTEOPOROSIS IN ASIAN AND CAUCASIAN WOMEN -- 1. Introduction -- 2. Epidemiology of fracture -- 2.1. Vertebral fracture -- 2.2. Hip fracture -- 3. Reduced bone density and fracture risk -- 4. Bone size and structural abnormalities in patients with fractures -- 5. Origins of bone fragility in Asian and Caucasian women -- 5.1. Growth-related origin -- 5.2. Menopause- and age-related origin -- 6. Structural and biomechanical basis of bone fragility -- 6.1. Vertebral skeleton -- 6.2. Proximal femur -- 7. Pathophysiologic mechanism of bone fragility -- 7.1. Estrogen deficiency -- 7.2. Secondary hyperparathyroidism -- 8. Summary and conclusion -- Acknowledgment -- REFERENCES -- CHAPTER 4 NUTRITION AND OSTEOPOROSIS -- 1. Introduction: The Causes of Osteoporotic Fragility -- Decreased Intrinsic Bone Strength -- Increased Propensity for Injury -- 2. Calcium -- The Skeleton as the Calcium Nutrient Reserve -- The Calcium Requirement and the Consequences of Suboptimal Calcium Intake -- Nutrient-Nutrient Interactions: Factors that Influence the Calcium Requirement -- Calcium Requirement and Body Size -- Calcium Sources -- 3. Vitamin D.

The Functioning of Vitamin D in the Calcium Economy -- Sources of Vitamin D -- 4. Protein -- 5. Phosphorus -- 6. Minerals and Trace Nutrients -- Trace Minerals -- Other Vitamins -- 7. Conclusion -- REFERENCES -- CHAPTER 5 BONE ADAPTATION TO MECHANICAL LOADING: HOW DOES BONE SENSE THE NEED FOR CHANGE TO LOADING FROM EXERCISE? -- Wolff's Law and the Mechanostat -- Characteristics of an Osteogenic Strain Stimulus -- Muscle-Bone Interactions -- Bone Adaptation: Mechanisms -- Physical Activity and Bone -- Immobilization -- What Types of Exercises are Osteogenic? -- Effects of Physical Activity During Growth -- Effects of Physical Activity in Adults -- Changes in Bone Size and Shape -- Factors that May Influence the Skeletal Response to Exercise -- Calcium -- Estrogen -- Estrogen Alternatives -- Summary -- REFERENCES -- CHAPTER 6 THE DIAGNOSIS OF OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN -- 1. Introduction -- 2. Skeletal Consequences of Estrogen Deprivation -- 2.1 Effects on Bone Mass -- 2.2 Effects on Bone Remodeling -- 2.3 Effects on Bone Structure -- 3. Quantitative Criteria for Identifying Osteoporosis -- 3.1 The WHO Criteria -- 3.2 Refinements of the WHO Criteria -- 4. A Comprehensive Approach to Diagnosis -- 4.1 A Broad Index of Suspicion -- 4.2 A Diagnosis of Exclusion -- 4.3 Authoritative Resources -- 5. Clinical Diagnosis -- 5.1 The Patient Interview -- 5.2 Physical Examination -- 5.3 Assessment of Bone Mass -- 5.4 Assessment of Bone Morphology -- 5.5 Laboratory Tests -- 5.6 Dietary Evaluation -- 6. Conclusions and Outlook -- REFERENCES -- CHAPTER 7 BIOCHEMICAL MARKERS OF BONE TURNOVER: ASSAY METHODS AND CLINICAL APPLICATION -- 1. Introduction -- 2. Biochemical markers of bone formation -- 2.1. Enzymes -- 2.2. Bone matrix protein -- 3. Biochemical markers of bone resorption -- 3.1. Ezymes -- 3.2. Collagen degradation products.

3.3. Non collagen bone matrix degradation product -- 4. Variability - a consideration when using biochemical markers -- 5. Clinical application of biochemical markers in osteoporosis -- 5.1. Monitoring response to antiresorptive drugs -- 5.2. Other potential clinical applications -- 6. Conclusion -- REFERENCE -- CHAPTER 8 BONE MARROW ADIPOGENESIS IN OSTEOPOROSIS -- 1. Introduction -- 2. Adipogenesis during bone marrow development -- 3. Function of marrow adipocytes -- 4. Transcriptional regulation of adipocyte differentiation -- 5. Relationship between adipogenesis and osteogenesis -- 6. Relationship between adipogenesis and hematopoiesis -- 7. Relationship between adipogenesis and osteoclastogenesis -- 8. Regulators and receptors for regulating adipogenesis and their therapeutic potentials for osteoporosis -- 8.1 Glucocorticoids and glucocorticoid receptor -- 8.2 1, 25 dihydroxyvitamin D and vitamin D receptor (VDR) -- 8.3 Estrogen, its analogs, and estrogen receptor -- 8.4 Growth hormone (GH) and growth hormone receptor (GHR) -- 8.5 PTH, PTHrP, and PTH/PTHrP receptor or G-protein coupling receptor -- 8.6 Leptin and leptin receptor -- 8.7 TGF- s, BMPs and their receptors -- 8.8 Proinflammatory factors and gp130 containing receptors -- 9. Summary -- REFERENCES -- CHAPTER 9 STATISTICAL METHODS IN OSTEOPOROSIS RESEARCH -- 1. Introduction -- 2. Basic Concepts of Statistics -- 2.1. Descriptive Statistics -- 2.2. Statistical Inferences -- 3. Statistics for Osteoporosis Diagnosis -- 3.1. Diagnosis of Osteoporosis -- 3.2. Sensitivity and Specificity and ROC Curves -- 3.3. Combination of Multiple Diagnostic Predictors -- 3.4. Assessment of Agreements -- 3.5. Comparisons Between Diagnostic Methods -- 3.6 Universal Standardization of BMD -- 4. Statistics for Osteoporosis Clinical Trials -- 4.1. General Issues in Osteoporosis Clinical Trials.

4.2. Quality Control and Quality Assurance in Osteoporosis Clinical Trials -- 5. Cost-Effective Analysis (CEA) for Osteoporosis Treatment -- 5.1 An Overview of Cost-Effective Analysis (CEA) -- 5.2 Markov Models -- 5.3 Interventions -- 5.4 Costs -- 5.5 Quality of Life Evaluations -- 5.6 Sensitivity Analysis -- 5.7 Use of CEA -- 5.8 Conflicts of Interests -- 5.9 CEA for Screening Strategies -- 5.10 Summary -- 6. Conclusion -- REFERENCES -- CHAPTER 10 PREVENTION AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS -- 1. Postmenopausal Osteoporosis Prevention -- 1.1. Risk Factors Modification -- 1.2. Adequate Dietary Calcium and Vitamin D -- 1.3. Regular Weight-Bearing Exercise -- 1.4. Fall Prevention -- 1.5. Pharmacological Prevention -- 2. PMO Treatment -- 2.1. Calcitonin -- 2.2. Raloxifene -- 2.3. Bisphosphonates -- 2.4. Teriparatide [rhPTH (1-34)] -- 3. Summary -- Acknowledgments -- REFERENCES -- CHAPTER 11 NOVEL POTENTIAL DRUG TARGETS FOR THE ANTI-RESORPTIVE TREATMENT OF OSTEOPOROSIS -- Introduction -- The Origin and Characteristics of Osteoclasts -- Osteoclastogenic Factors -- RANKL/RANK/OPG -- Other Osteoclastogenic Factors -- Intracellular Signalling Molecules -- AP-1 Pathway -- NF-kB Pathway -- Protein Kinase B/Akt Pathway -- NF-AT Pathway -- c-Src -- Cell Fusion Molecules -- Integrins -- Enzymes -- Cysteine Protease and Cathepsin K -- Matrix Metalloproteinases -- Conclusion -- REFERENCES -- CHAPTER 12 MALE OSTEOPOROSIS -- 1. Epidemiology of Male Osteoporosis -- 2. Causes of Male Osteoporosis -- 2.1. Primary Cause of Male Osteoporosis -- 2.2. Secondary Cause of Male Osteoporosis -- 3. Evaluation of Male Osteoporosis -- 4. Prevention and Treatment of Male Osteoporosis -- 4.1. Testosterone -- 4.2. Alendronate -- 4.3. Risedronate -- 4.4. Teriparatide -- 5. Summary -- Acknowledgments -- REFERENCES -- CHAPTER 13 OSTEOPOROSIS AND OSTEOARTHRITIS.

Association between osteoporosis or bone mineral density and prevalence of osteoarthritis -- Relation of osteoporosis or bone mineral density to the incidence or progression of osteoarthritis -- Possible mechanisms underlying the relationship between osteoporosis and osteoarthritis -- Conclusion -- REFERENCES -- CHAPTER 14 OSTEOPOROSIS IN PEDIATRICS -- 1. Introduction -- 2. Primary osteoporosis in pediatrics -- 2.1. Nutritional Rickets -- 2.2. Vitamin D pseudodeficiency (PDDR) -- 2.3. Hereditary 1,25-dihydroxyvitamin D resistant rickets (HVDRR) -- 2.4. Osteogenesis imperfecta (brittle bones disease) -- 2.5. Syndromes resembling osteogenesis imperfecta (SROI) [139] -- 2.6. Idiopathic Juvenile Osteoporosis -- 2.7. Hypophosphatasia -- 2.8. Hyperphosphatasia -- 2.9. Primary hypomagnesemia -- 3. Secondary osteoporosis in pediatrics -- 3.1. Immobilization -- 3.2. Neuromuscular diseases -- 3.3. Type I diabetes mellitus -- 3.4. Renal causes -- 3.5. Hypogonadism -- 3.6. Malabsorption -- 3.7. Inborn errors of metabolism -- 3.8. Malignancy and steroid induced osteoporosis -- 3.9. Prematurity -- 3.10. Juvenile rheumatoid arthritis -- 3.11. Drugs and toxics -- 4. Work-up -- 5. Treatment -- REFERENCES -- CHAPTER 15 GENETICS OF OSTEOPOROSIS -- 1. Introduction -- 2. Evidence for Genetic Basis of Osteoporosis and Associated Traits -- 3. Searching for Osteoporosis Genes -- 3.1. Candidate Gene Association Studies -- 3.2. Linkage Studies -- 3.3. Gene Expression Studies -- Acknowledgment -- REFERENCES -- CHAPTER 16 PHARMACOGENETICS AND PHARMACOGENOMICS OF OSTEOPOROSIS -- Introduction -- Pharmacogenetics Approaches -- Previous Studies -- Experimental Design -- Factors Influencing the Power of Genetic Association Study -- Pathway Approaches -- Haplotype Analysis and Tagging SNPs -- Population Admixture/Stratification -- Pharmacogenomic Strategies for Osteoporosis.

Genome-wide Association Approach.