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Physiological Reviews, Vol. 81, No. 1, January 2001, pp. 419-447
Copyright ©2001 by the American Physiological Society
Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
Compston, Juliet E.
Sex Steroids and Bone. Physiol. Rev. 81: 419-447, 2001.
Sex steroids are essential for skeletal
development and the maintenance of bone health throughout adult life,
and estrogen deficiency at menopause is a major pathogenetic factor in
the development of osteoporosis in postmenopausal women. The mechanisms by which the skeletal effects of sex steroids are mediated remain incompletely understood, but in recent years there have been
considerable advances in our knowledge of how estrogens and, to a
lesser extent androgens, influence bone modeling and remodeling in
health and disease. New insights into estrogen receptor structure and
function, recent discoveries about the development and activity of
osteoclasts, and lessons learned from human and animal genetic
mutations have all contributed to increased understanding of the
skeletal effects of estrogen, both in males and females. Studies of
untreated and treated osteoporosis in postmenopausal women have also
contributed to this knowledge and have provided unequivocal evidence
for the potential of high-dose estrogen therapy to have anabolic
skeletal effects. The development of selective estrogen receptor
modulators has provided a new approach to the prevention of
osteoporosis and other major diseases of menopause and has implications
for the therapeutic use of other steroid hormones, including androgens. Further elucidation of the mechanisms by which sex steroids affect bone
thus has the potential to improve the clinical management not only of
osteoporosis, both in men and women, but also of a number of other
diseases related to sex hormone status.
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