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Abstract
Estrogen plays an important role in the growth and maturation of bone as well as in
the regulation of bone turnover in adult bone. During bone growth estrogen is needed
for proper closure of epiphyseal growth plates both in females and in males. Also
in young skeleton estrogen deficiency leads to increased osteoclast formation and
enhanced bone resorption. In menopause estrogen deficiency induces cancellous as well
as cortical bone loss. Highly increased bone resorption in cancellous bone leads to
general bone loss and destruction of local architecture because of penetrative resorption
and microfractures. In cortical bone the first response of estrogen withdrawal is
enhanced endocortical resorption. Later, also intracortical porosity increases. These
lead to decreased bone mass, disturbed architecture and reduced bone strength. At
cellular level in bone estrogen inhibits differentiation of osteoclasts thus decreasing
their number and reducing the amount of active remodeling units. This effect is probably
mediated through some cytokines, IL-1 and IL-6 being strongest candidates. Estrogen
regulates the expression of IL-6 in bone marrow cells by a so far unknown mechanism.
It is still uncertain if the effects of estrogen on osteoblasts is direct or is due
to coupling phenomenon between bone formation to resorption.
Keywords
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© 1996 Published by Elsevier Inc.
