Ayotunde Oladunni Ale

By Ayotunde Oladunni Ale

Adequate amount of thyroid hormone is an essential requirement for normal development and maturity of bones in the early life as well as for the maintenance of the skeletal system (bone remodeling). Osteoporosis, one of the most common metabolic bone disorders, is strongly associated with hyperthyroidism (endogenous and exogenous), whereas association of the same disease with hypothyroidism is not quite established. Most of the data describing the association between osteoporosis and hyperthyroidism are collected among elderly population (especially postmenopausal women), and only a few studies in literature researched into osteoporosis and hyperthyroidism in <50 years of age; hence further studies are required in the younger population (including premenopausal women and younger males).

Part of the book: Clinical Implementation of Bone Regeneration and Maintenance

By Ayotunde Oladunni Ale, Oluwayomi Akande and David Da Rocha-Afodu

Calcium homeostasis has a pivotal role in regulating many biological processes. The interplay of calcium-regulating hormones, including parathyroid hormone (PTH), vitamin D, and calcitonin, is crucial in tightly maintaining serum calcium levels. Deregulation of calcium homeostasis has clinical implications resulting in hypercalcemia or hypocalcemia, which can lead to metabolic bone disease (MBD). MBD is a group of multifactorial bone diseases, caused by bone demineralization and characterized by an increased susceptibility to fracture risk. This chapter aims to provide an overview of associated risk factors and diagnostic, prevention, and recent treatment methods for MBD. The diagnosis of MBD is based on the assessment of clinical signs, radiological findings, quantitative ultrasonography, and biochemical evaluation of serum calcium, phosphate, PTH, alkaline phosphatase, and vitamin D. Current pharmacological treatments include antiresorptive and anabolic conventional therapies. Additionally, the efficacy of herbal extracts and nutritional supplements have been evaluated. Recent advances in the MBD management include drugs targeting calcium-sensing receptor and parathyroid hormone-related proteins, leading to the development of cathepsin K and Src tyrosine kinase inhibitors, calcilytics, and monoclonal antibodies against sclerostin or Dickkopf-1. Moreover, new nanomaterials have been used for improving the surgical treatment of vertebral fractures.

Part of the book: Mineral Deficiencies