THE ROLE OF HORMONAL FACTORS IN THE DEVELOPMENT OF OSTEOPOROSIS

Abstract

Osteoporosis is a common systemic skeletal disease characterized by decreased bone mineral density and impaired bone quality, resulting in increased bone fragility and a higher risk of fractures. The maintenance of skeletal integrity depends on a complex network of hormonal regulators that coordinate bone formation and resorption throughout life. Among these, sex steroids, parathyroid hormone, vitamin D, glucocorticoids, growth hormone, insulin-like growth factor-1 (IGF-1), calcitonin, and thyroid hormones play key roles in preserving normal bone remodeling. Hormonal influences on bone health are particularly evident during ageing. In women, menopause-related estrogen deficiency is the major factor driving accelerated bone loss, largely through increased osteoclast activity and disruption of the regulatory pathways that maintain the balance between bone resorption and bone formation. In men, age-associated declines in testosterone and IGF-1 also contribute to progressive deterioration of both cortical and trabecular bone. This review examines the major hormonal mechanisms involved in the pathogenesis of osteoporosis and highlights recent advances in our understanding of endocrine regulation of bone metabolism. Particular attention is given to the clinical implications of these hormonal interactions for the diagnosis, prevention, and treatment of osteoporosis.