Secondary Osteoporosis: Endocrine and Metabolic Causes of Bone Mass Deterioration

Secondary osteoporosis results from medical conditions or treatments that interfere with the attainment of peak bone mass and/or may predispose to accelerated bone loss. Although secondary osteoporosis is less common, it is becoming more frequently diagnosed. Apart from the well-defined risk of secondary osteoporosis in patients requiring long-term corticosteroids therapy, an increasing list of dietary , lifestyle, endocrine, metabolic, and other causes of bone mass deterioration has been identified (Table 1). Recently it has been demonstrated that, in contrast to primary osteoporosis which is associated with age, gender, and family history, secondary osteoporosis shows a prevalence in men similar to that in women (men 21% versus women 17.5%) [1]. However, at presentation with a recent clinical vertebral or nonvertebral fracture, at least 27% of patients have previously unknown contributors to secondary osteoporosis, which are treatable or need follow-up [2]. Therefore, a careful medical examination always should be carried out in each patient with a recent fracture to exclude potentially reversible causes of bone loss. In comparison with primary osteoporosis, treatment of secondary osteoporosis is usually more complex and requires treating the underlying disease. The main focus of this special issue is on current research that advances our understanding of the mechanisms underlying the endocrine and metabolic causes of bone mass deterioration. In the paper " Bone mineral density accrual determines energy expenditure with refeeding in anorexia nervosa and supersedes return of menses, " the authors in the clinical study examined the disproportionate increase in resting energy expenditure that occurs with refeeding of women with anorexia nervosa to determine if it was related to bone mass increase. They found that prolonged nutritional rehabilitation may lead to recovery from osteopenia (a common finding in anorexia nervosa) and resumption of menses in the women who remain amenorrheic with low bone mineral density (BMD). The paper entitled " Protective role of black tea extract (BTE) against non-alcoholic steatohepatitis (NASH)-induced skeletal dysfunction " was aimed to examine the chemoprotective actions of aqueous BTE on decreased BMD induced by nonalcoholic steatohepatitis in the Wistar rats. Some previous studies have suggested that habitual tea consumption might have beneficial effect on BMD in adults. In this study, the authors confirmed this suggestion in rats and also found that BTE may influence levels of RANKL, osteoprotegerin, and bone turnover markers. The paper " Bone health in patients with multiple sclerosis " describes the up-to-date diagnostic criteria and includes detailed …