What do we really know about osteoporosis?

Bone remodeling is the best known process, as well as bone resorption and formation. We know the osteoporosis epidemiology. Bone loss happens at two well-defined stages of life, during menopause, the so called postmenopausal osteoporosis and during old age, senile osteoporosis. There are other situations that can cause bone loss, this would be secondary osteoporosis. As for genetics, this is the field that has showed more innovations in the last two decades. Numerous candidate genes have been studied, finding clear associations between some of them and the bone mineral mass measured and specially with osteoporetic fractures. Currently, bone densitometry is the diagnostic method accepted and considered for osteoporosis, but we do not know what factors, other than bone mineral density, can dicrease the number of fractures. We know from several controlled clinical trials that Hormone Replacement Therapy, Raloxifen, Alendronate, Risedronate and PTH are effective drugs in the reduction of fracture risk. In conclusion, the field of osteoporosis has progressed considerably, but in future years we will see big innovations both in the genetic and the therapeutic field.