药物靶向、分子靶向、激素靶向及干细胞靶向与骨质疏松症的治疗

背景：骨质疏松症引起的骨折及其他并发症严重影响中老年人生活质量。 目的：探讨靶向疗法治疗骨质疏松的进展,以促进其临床应用。 方法：由第一作者应用计算机检索PubMed、中国期刊全文数据库(CNKI)中1997-05/2011-12相关文献。在标题、摘要、关键词中以“targeted therapy,bone target,stem cell,osteoporosis,treatment”或“靶向治疗,骨靶向,干细胞,骨质疏松,治疗”为检索词进行检索。选择文章内容与靶向疗法治疗骨质疏松有关者,同一领域则选择近期发表在权威杂志上的文章。 结果与结论：初检得到148篇文献,根据纳入标准选择38篇文献进行综述。靶向治疗骨质疏松已成为骨质疏松治疗中的研究热点。目前研究领域涉及药物靶向、分子靶向、激素靶向、受体靶向及干细胞靶向治疗等,其中药物、分子及激素靶向疗法为目前常用的治疗方法,常用药物有四环素、双膦酸盐类、Denosumab等。但目前靶向治疗骨质疏松尚未完全成熟,所导致的临床不良反应限制其应用进展,仍有许多问题有待解决。     

失用性骨质疏松症的发病机制及预防治疗进展

背景：失用性骨质疏松较为常见,因其特殊的病因,预防治疗缺乏有效手段,给社会和家庭带来了巨大的负担。 目的：分析失用性骨质疏松的病因、发病机制及预防治疗方法,为失用性骨质疏松的有效预防提供参考。 方法：检索CNKI和PUBMED数据库,2002年1月至2012年9月收录的失用性骨质疏松症的相关文献,中文检索词为“废用性骨质疏松或失用性骨质疏松”,共检索到中文67篇;英文检索词为“disuse osteoporosis AND English”检索到111篇相关文献,对文章进行初审,纳入文献主题与此文联系密切,原创、论点论据可靠的文章,观点明确,分析全面的文章;排除内容陈旧或重复文献及试验设计不是随机对照试验的文章。 结果与结论：共纳入符合标准的文献50篇(中文25篇,英文25篇)。目前对失用性骨质疏松症的病因大致归为3大类,即机械负重的减少、微重力状态、脊髓及神经损伤。失用性骨质疏松的预防和治疗主要有：药物预防治疗,包括降钙素、中草药、双膦酸盐、维生素、钙、锶盐及神经生长因子等;物理治疗：脉冲电磁场、超声波、共振波、被动运动及电针治疗。目前临床上对失用性骨质疏松症没有理想的预防治疗措施,近年来研究者们开始试图从遗传学角度探讨其发病机制,在一些信号通道蛋白、特异性基因位点的研究中取得了一定进展。     

运动防治膝骨关节炎的关键因素及注意事项

文题释义： 运动疗法：是指利用器械、徒手或患者自身力量,通过某些运动方式(主动或被动运动等),使患者获得全身或局部运动功能、感觉功能恢复的训练方法。运动疗法主要采用“运动”这一机械性的物理因子对患者进行治疗,着重进行躯干、四肢的运动、感觉、平衡等功能的训练,包括：关节功能训练、肌力训练、有氧训练、平衡训练、易化训练、移乘训练、步行训练。 骨关节炎：为一种退行性病变,系由于增龄、肥胖、劳损、创伤、关节先天性异常、关节畸形等诸多因素引起的关节软骨退化损伤、关节边缘和软骨下骨反应性增生,又称骨关节病、退行性关节炎、老年性关节炎、肥大性关节炎等。临床表现为缓慢发展的关节疼痛、压痛、僵硬、关节肿胀、活动受限和关节畸形等。 背景：目前膝骨关节炎的治疗以缓解症状为主,真正根治较难。运动疗法是为了达到一些特定的治疗目标而专门设计和规范的体育活动计划,旨在恢复正常的肌肉骨骼功能和减少疾病或身体损伤引起的疼痛。有关运动疗法防治膝骨关节炎存在不同观点。 目的：探讨影响运动疗法防治膝骨关节炎疗效中的关键因素及注意事项,为运动疗法防治膝骨关节炎提供一定参考依据。 方法：应用计算机检索至2019年1月PubMed数据库、中国期刊全文数据库相关文章,英文检索词为：“exercise therapy,knee osteoarthritis,prevention and treatment”;中文检索词为：“运动疗法,膝骨关节炎,防治”。根据纳入排除标准,对检索到的关于运动疗法对膝骨关节炎作用的相关文献进行分析。 结果与结论：①运动疗法应尽早介入,早期需注意各部损伤时膝关节的角度问题,需逐渐增加活动度及强度,可以从非负重训练开始到后期训练可以负重;②运动疗法的强度应以中小强度为主,避免过度训练,特别是对于软骨磨损的患者。 ORCID: 0000-0002-1708-5181(宋校能) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

对骨质疏松性慢性疼痛:如何认知和预防?

背景:对于骨质疏松症的治疗,临床医师一般只关注骨密度的改善和降低骨折的发生率,却往往忽视与提高患者生活质量密切相关的缓解骨质疏松性慢性疼痛的治疗。目的:就目前国内外有关骨质疏松性慢性疼痛的研究现状做一概述,以期对骨质疏松性慢性疼痛的基础研究和临床治疗有所帮助。方法:应用计算机检索1999年3月至2014年3月万方医学网及PubMed数据库,以"骨质疏松;疼痛;骨质疏松性骨折;经皮椎体成形术"或"Osteoporosis;Chronic pain;Treatment of Osteoporotic;Vertebral Compression Fracture"为检索词进行检索。检索与骨质疏松性慢性疼痛特点、发病机制、药物治疗相关的文献,以及与骨质疏松性椎体压缩性骨折外科治疗相关的文献。最终纳入49篇文章进行分析。结果与结论:骨质疏松慢性疼痛的发病机制有淤血机制,细胞因子和乳酸堆积机制等,但其确切的细胞生化机制尚不十分明确。常用的药物治疗降钙素、二膦酸盐等,降钙素通过抑制骨吸收间接降低氢离子浓度,抑制前列腺素的合成,提高动物痛阈,提高血浆β-内啡肽浓度,而起到镇痛作用。二膦酸盐主要药理作用是抑制破骨细胞生成及其活性,抑制骨吸收,改善骨质疏松性骨痛,显著提高骨密度,增加骨强度,预防骨质疏松性骨折的发生。骨质疏松脊柱压缩性骨折及脊柱良恶性肿瘤采用经皮椎体成形或经皮椎体后凸成形治疗,完全或部分恢复椎体丢失高度,纠正后凸畸形,增加椎体稳定性,缓解疼痛。多种治疗方法联合为骨质疏松慢性疼痛行可行有效的治疗措施,同时,有效防治骨质疏松性骨折的发生对骨质疏松慢性疼痛的防治也具有积极促进作用。     

绝经后骨质疏松症的预防和药物联合序贯治疗

背景:绝经期后的妇女由于雌激素水平下降导致骨吸收迅速增加,造成骨吸收和形成之间的不平衡,增加了骨质疏松和相关部位骨折的风险。然而,目前的临床防治并不足以抑制长期的骨丢失和不断增加的骨折风险。近年来,针对绝经后骨质疏松症及时有效的预防和抗骨质疏松药物序贯联合治疗已成为必然趋势。目的:就绝经后骨质疏松症的预防和抗骨质疏松药物治疗的相关文献进行总结,介绍绝经后骨质疏松症的临床预防措施和常见的抗骨质疏松药物联合序贯治疗进展。方法:作者于2020年1月应用计算机检索2009年1月至2019年12月中国期刊全文数据库CNKI、万方和PubMed数据库的相关文章,中文检索词"绝经后骨质疏松症,预防,药物,治疗";英文检索词"Postmenopausal osteoporosis,prevention,drug therapy,medication",根据纳入标准及排除标准摘选41篇文章进行分析讨论。结果与结论:①绝经后妇女要及时进行骨密度测试,通过改变饮食结构和生活方式进行预防,以降低骨折风险;②与单一药物相比,联合序贯疗法可以更有效地治疗绝经后骨质疏松症,对绝经后骨质疏松症的治疗具有深远的意义。     

不同模式下血流限制治疗老年性肌肉减少症的效果与安全因素

背景:有研究报道了血流限制疗法对中老年肌肉适能的影响与优势,基本肯定了血流限制疗法应用的科学性和其改善中老年人肌力及肌肉量的有效性,但关于不同运动模式下的血流限制疗法在老年性肌肉减少症中的应用以及相关作用机制的综述国内外还未见报道。目的:综述不同运动模式下的血流限制疗法应用于老年性肌肉减少症的应用效果、安全性及不良反应,为此类患者选择科学有效的治疗方式提供新的思路。方法:在PubMed、ScienceDirect、Web of Science、万方、维普、CNKI数据库检索2005年1月至2020年7月收录的相关文献,英文检索词为“blood flow restriction or exercise or therapy;KAATSU training;sarcopenia;motor function;mechanism”;中文检索词为“血流限制疗法;血流限制训练;血流限制;加压血流阻滞训练;加压训练;老年性肌肉减少症;肌少症;少肌症;肌肉力量;运动功能;机制”,经筛选后对50篇文献进行归纳总结。结果与结论:①在老年性肌肉减少症患者中使用血流限制疗法可增加肌肉力量和肌容积,尤其是与中低强度抗阻运动结合的效果最佳且不良反应少;②血流限制疗法可能通过增加肌肉组织蛋白合成与降解速率、提高线粒体能量代谢水平及改善组织微循环水平发挥作用,但目前血流限制疗法发挥作用的机制仍存在争议,需进一步研究加以论证;③在老年性肌肉减少症患者中使用血流限制疗法尚无明确的安全性结论,使用中需重点关注血流闭塞压力和运动负荷情况。     

电刺激与运动联合干预绝经后骨质疏松模型大鼠骨代谢及血清学指标的改变

背景：电刺激与运动皆能对去势大鼠骨代谢产生良好影响,但关于电刺激和运动联合干预去势大鼠至今少有报道。 目的：观察适宜健骨运动处方与电刺激联合干预对绝经后骨质疏松的影响。 方法：将大鼠随机分为假手术组,骨质疏松模型组,运动组,电刺激组和运动+电刺激组,后4组建立骨质疏松大鼠模型并进行相应的干预。 结果与结论：干预后60 d,与骨质疏松模型组比较,运动结合电刺激组骨钙素浓度增高(P < 0.05),运动组、电刺激组、运动结合电刺激组抗酒石酸盐酸性磷酸酶活性低(P < 0.01),雌二醇水平显著升高(P < 0.05)。结果证实,运动处方结合低频电刺激联合作用能够更好地促进骨质疏松模型大鼠骨形成和抑制骨吸收,减少破骨细胞分泌和阻止骨丢失。 关键词：电刺激;运动;骨质疏松;骨代谢;骨组织构建 doi:10.3969/j.issn.1673-8225.2012.07.004     

原发性骨质疏松易发年龄段骨代谢相关激素的变化

我国是世界上老年人口最多的国家,预测目前有骨质疏松患者约8400万[l].尽管原发性骨质疏松症在很大程度上取决于遗传因素及相关基因的影响,但后天的生长、发育、营养、运动、生活习惯、生存环境等因素亦不容忽视[2l.已有大量资料证实了对其防治的有效性及积极作用.因此,在治疗骨质疏松症的同时,如何预防或延缓及减轻骨质疏松的发生发展极为重要.     

耐力运动对青年与老年小鼠股骨组织微结构变化的影响

目的　应用原子力显微镜（atomic force microscope,AFM）观察中等强度耐力运动后青年与老年小鼠股骨组织微结构的变化,并探讨耐力运动对预防和改善骨质疏松的适宜年龄阶段。 方法　不同月龄清洁级雄性C57小鼠40只,平均分为3月龄青年组和16月龄老年组,每组再平均分为对照组和运动组。青年及老年运动组使用转棒仪跑步运动12周,运动参数15 r/min,25 min/日。对照组正常饲养。实验结束后处死各组小鼠取股骨,石蜡包埋切片后通过AFM观察小鼠股骨皮质骨组织微结构。 结果　青年对照组可见骨陷窝环绕哈弗系统排列规则,有骨小管与其相沟通,钙磷晶体部分呈小柱状,部分呈团状分布;与青年对照组相比青年运动组可见骨陷窝数量及大小变化,表面粗糙度显著降低（P＜0.05）,提示骨组织表面平滑度增加,骨量增加;与青年对照组相比老年对照组可见骨陷窝数量大小变化,钙磷晶体数量减少,表面粗糙度显著增高（P＜0.05）,提示存在骨质疏松;与老年对照组相比老年运动组可见骨陷窝及钙磷晶体数量及大小无明显改变,表面粗糙度改变无统计学意义。 结论　中等强度耐力运动可以改善青年小鼠骨组织微结构,提高骨质量,但对已经发生骨质疏松的老年小鼠骨微结构无明显改善。提示老年骨质疏松的运动预防可能需要从成年开始。     

去势雌性山羊骨质疏松模型的特点

背景：加强骨质疏松模型的研究,对骨质疏松性骨折的防治非常必要。 目的：综述现有的山羊骨质疏松模型的特点,为骨质疏松和骨质疏松性骨折的防治提供帮助。 方法：应用计算机检索中国知网和PubMed数据库中2005-06/2011-02关于去势雌性山羊骨质疏松模型的文章,在标题和摘要中以“骨质疏松症、动物模型、山羊、卵巢切除”或“osteoporosis, animal model, goats, ovariectomy”为检索词进行检索。选择文章内容与建立骨质疏松模型的方法、评价标准,骨质变化等有关的研究,排除重复研究及建立雄性动物骨质疏松模型的研究。 结果与结论：初检得到48 篇文献,根据纳入标准选择21篇文章进行综述。山羊来源方便,容易处置,具有自动排卵和与成年妇女相似的排卵周期,是理想的实验动物材料;能获取大量血、尿和骨骼标本,是理想的制备骨质疏松模型的实验动物。去势法是建立骨质疏松模型常用的方法,山羊骨质疏松模型的建立将为骨质疏松和骨质疏松性骨折防治药物的开发、改进内置物设计等提供研究的基础。 关键词：卵巢切除术;骨质疏松;模型;雌激素;骨代谢;山羊 doi:10.3969/j.issn.1673-8225.2012.07.038             

骨质疏松症治疗中的运动疗法

背景：骨质疏松症是以骨量减少、骨组织显微结构退化为特征,以致骨的脆性增高而骨折危险性增加的一种全身骨病,通常治疗的首要手段为药物治疗。而单纯药物治疗无法提高肌肉力量,改善平衡功能,进而预防跌倒的发生,因此已不能满足骨质疏松症的综合管理。运动作为一种重要的非药物治疗手段,在骨质疏松症的预防中公认应作为首选,在骨质疏松症的治疗中的重要性逐渐被认识。 目的：结合最新的一些研究文献,探讨运动在骨质疏松症治疗中的作用。 方法：以“骨质疏松症,骨密度,骨强度,治疗,运动,应力,太极,肌肉,骨组织构建”为中文检索词,以“osteoporosis,bone mineral density, bone strength, treatment,exercise,stress,tai chi,muscle,bone architecture”为英文检索词,检索中国知网(CNKI)期刊全文数据库和Medline 2001年1月至2013年2月有关不同运动类型对人骨强度的影响特别是对骨质疏松症患者的治疗作用的临床报道及机制研究。排除重复性研究和不典型报道。 结果与结论：治疗性运动包括有氧运动、抗阻运动、冲击性运动、振动运动等类型,可以安全的提高骨强度,提高肌肉力量,改善平衡功能,预防跌倒和骨折。对于脊柱畸形者适当选用矫形器可提高安全性、促进运动治疗。与药物治疗一样,运动治疗也遵循个体化原则,在良好的依从性和安全性条件下进行运动方案的选择,各种运动的效果均较小,包含高应变速率的运动似乎更有效,但均需要长期坚持运动以维持疗效。     

Osteoporotic fractures: background and prevention strategies

Objectives: To review current knowledge of the epidemiology, pathogenesis, prevention and treatment of osteoporosis, with particular reference to issues related to the menopause. Methods: Peer-reviewed publications were assessed. Results: Much international variation exists in the prevalence of osteoporosis and the incidence of fracture. Risk fractures for osteoporosis are numerous. The menopause and other causes of hypogonadism in both women and men strongly predispose to osteoporosis. Various endocrinopathies, especially glucocorticoid excess, also are important. The contribution of family history may be explained by one or more genetic markers. Poor vitamin D and calcium nutrition, smoking, high alcohol consumption and inactivity increase risk. Reduced bone mass is a major risk factor for fracture, although the magnitude of that risk may vary between populations. In addition, bone fragility, length of the femoral neck (for hip fracture), history of prior fracture (for vertebral fracture) and falls affect fracture risk. Useful methods for measuring bone density are available for both epidemiologic surveillance and for clinical practice. Dual energy x-ray absorptiometry is the most desirable method in clinical care settings. Some risk factors can be modified for prevention of osteoporosis. Postmenopausal bone loss can be inhibited with estrogen or estrogen plus progestin therapy. Bone loss in the elderly may be moderated with calcium and vitamin D supplementation. Maintenance of muscle tone and strength through exercise may reduce falls. Conclusions: Osteoporosis is a large and growing health problem in many countries. Prevention of osteoporosis is a high priority, especially because treatment of the established disease remains sub-optimal. Prevention requires immediate, intermediate-term and long-term strategies. First line therapy for established osteoporosis in women in many countries is estrogen or estrogen plus progestin, calcium and vitamin D. Prospects for improved prevention of osteoporotic fractures are encouraging.     

绝经期妇女骨质疏松症与心血管疾病

世界不同地区妇女平均绝经年龄为５０岁。世界银行１９９０年人口调查报告指出，５０岁以上妇女约有４７亿，预计２０３０年将增至１２亿。中国５０岁以上的妇女将占世界总数的２３％，为世界首位。年龄别心血管疾病死亡率妇女低于男子，但随年龄增加至７５岁时妇女与男...     

运动在模拟失重尾吊大鼠模型中的应用及对肌骨系统改善的研究进展

大鼠作为模拟人类骨骼状态的常用实验动物模型,被广泛用来探寻对抗骨质疏松的有效措施,其中运动疗法既安全又有效.宇航员长期处于微重力环境会发生失重性骨质疏松,相应的大鼠尾吊模型作为地面模拟微重力效应的实验模型已得到广泛应用.文中综述了应用在尾吊和非尾吊大鼠实验中的运动训练,力图涵盖运动训练对抗大鼠骨质疏松的国内外研究进展,并对今后模拟微重力下大鼠运动方式的研究方向做了展望.     

What is the impact of osteoporosis education and bone mineral density testing for postmenopausal women in a managed care setting?

OBJECTIVE: To assess whether osteoporosis education, with and without bone mineral density (BMD) testing, increases the initiation of lifestyle changes and pharmaceutical treatment to prevent osteoporosis. DESIGN: A total of 508 women, aged 54-65, from a large managed care organization who were not on osteoporosis prevention therapy participated in an intervention study. Participants were randomly assigned to either an education class on osteoporosis (n = 301) or education plus BMD (n = 207). A control group of 187 women receiving no intervention were also surveyed to serve as comparison. Group differences and differences based on BMD test result were compared 6 months after education regarding self-reported changes in health behaviors using chi2 tests and logistic regression analyses. RESULTS: Of the 508 intervention participants, 455 (90%) responded to the follow-up survey. Initiation of hormone replacement therapy was reported by 9%, with 5% reporting starting alendronate. More than half reported changes in diet, exercise, or calcium intake. Forty-three percent increased their vitamin D intake. There were no significant group differences in behavior except with regard to pharmaceutical therapy; subjects with education plus BMD were three times more likely than those receiving education only to report starting hormone replacement therapy (p = 0.004). Low BMD scores were associated with increasing vitamin D intake (p = 0.03) and starting medication (p = 0.001). Women in the intervention groups were significantly more likely to report modifying their diet (p < 0.001), calcium (p < 0.01), and vitamin D intake (p < 0.0001) than women in the control group, not exposed to education. CONCLUSION: Education regarding osteoporosis prevention seems to encourage women to make lifestyle changes. The inclusion of BMD testing enhances the likelihood that women will consider pharmaceutical therapy.     

Women''s use of hormone replacement therapy for relief of menopausal symptoms, for prevention of osteoporosis, and after hysterectomy.

BACKGROUND. Hormone replacement therapy is used for the relief of menopausal symptoms. In the United Kingdom, guidelines have been developed for the use of hormone replacement therapy in the prevention of osteoporosis, and in the United States of America its use has also been recommended for cardiovascular disease prevention. However, compliance has been found to be a problem, and rates of prescribing vary between general practitioners. AIM. This study set out to describe the prescribing of hormone replacement therapy in one general practice, to enable doctors to plan future prescribing and promotion of hormone replacement therapy, taking into account constraints on its use. METHOD. The patient records of users of hormone replacement therapy were examined to collect data on menopausal status, reason for use, length of use, breaks from therapy and reasons for stopping therapy. Women with a history of hysterectomy and with risk factors for osteoporosis were identified from the practice morbidity register. Their use of hormone replacement therapy was recorded. RESULTS. Of women aged 40-59 years on the practice list, 348 were taking hormone replacement therapy (20%). Of 107 women aged under 52 years who had had a hysterectomy and bilateral oophorectomy 76 were taking therapy (71%). Of 158 women under the age of 52 years who had had a hysterectomy with preservation of the ovaries 39 were taking therapy (25%). Among women taking hormone replacement therapy for the relief of menopausal symptoms, the highest rate of use was among those aged 50-54 years where 93 were on therapy (24% of women in that age group in the practice). Twenty out of 47 women with a recorded risk factor for osteoporosis were taking therapy. More than three quarters of women using hormone replacement therapy appeared to be taking it continuously. CONCLUSION. The uptake of hormone replacement therapy was found to be high for women with a surgical menopause, the group most easily identifiable as at risk of osteoporosis. Women who decided to take therapy appeared to take it continuously, and therefore effectively for prevention. Rate of uptake, rather than compliance, is more likely to constrain its use in prevention.     

深蹲的国内外最新生物力学研究进展

高屈曲膝关节活动在亚洲国家的日常生活及某些职业中极为常见。归纳深蹲的总种类及其动作特点,综述近年来有关深蹲的生物力学研究进展,并对离体实验、在体测试和计算机模拟等不同研究方法进行分类阐述。开展膝关节深蹲动作的生物力学研究,有益于建立合理的康复训练和运动风险预防方案,为膝关节假体优化设计提供一定参考建议。     

Langzeitkontrazeption

Long-acting contraceptives represent a highly effective family planning strategy due to their independence from user compliance. The development of new progestogen-containing methods has broadened the scope of choices considerably. Health risks seem to be minimal. The long-term risk of osteoporosis is questionably present in long-term depot medroxyprogesterone acetate (DMPA) users. The focus for acceptability lies in the effects of these methods on the quality of life of the users. Important outcome parameters are bleeding pattern, weight, skin, hair, psychological well-being, sexual experience, and behavior. At present there are no systematic comparative studies. The available data for the different methods vary greatly with probable differences regarding specific side effects. Based on these data, the actual profile of the methods is summarized and compared, especially to female sterilization. For the future three main tasks emerge: basic research regarding the effects of progestogens on the endometrium, comparative studies regarding quality of life during long-term contraception using a validated and standardized instrument, and further development of different progestogen types, dosages, and application forms.     

Preclinical development of agents for the treatment of osteoporosis.

Because of the high cost and long time frame of clinical testing, animal models play a crucial role in the identification and selection of agents for the treatment of osteoporosis. The use of animal models early in a program focuses on the establishment of efficacy, while animal models used later in a program to examine bone safety. More specifically, animal models are used to gain information on the skeletal mechanism of action, to examine multiple skeletal sites (axial and appendicular), and to examine the effects of higher doses than will be used in humans. Animal models also predict the usefulness of surrogate markers in clinical trials, such as formation and resorption markers, as well as bone density. The hazard of using surrogate markers for fracture prevention is highlighted by high dose fluoride administration, which can increase bone density (considered a strong predictor of fracture protection) while not protecting against fractures. Estrogen-deficient models are most commonly used to mimic the postmenopausal bone loss in women; these models are characterized by increased bone turnover and a negative bone balance. The timing of the administration of the new therapy in animal models can help determine whether the agent will be more effective in the prevention of osteoporosis or in the treatment of established osteoporosis. New methods for the measurement of bone mass or volume are less invasive, require shorter acquisition time, and have enhanced resolution, resulting in increased knowledge concerning architectural changes and specific sites of bone deposition. Finally, the measurement of biomechanical strength of bones from animal models can be used to predict protective effects on fracture rates in clinical trials. When used in combination with other methods, animal models can greatly increase our understanding of the pathophysiology of osteoporosis and can expedite the development of new therapies.