- Bone is a metabolically active tissue that undergoes constant remodeling.
- The major cells involved in the remodeling process are the osteoclast and osteoblast.
- Bone metabolism is closely interrelated with the metabolism of calcium which also involves the intestine and kidney.
- A calcium sensing receptor is present on the parathyroid, thyroid and kidney cells that is pivotal in calcium regulation.
- The calcium balance is hormonally regulated by parathormone, vitamin D metabolites and calcitonin.
- The measurement of calcium in serum is an important test in the clinical laboratories, because both hypercalcemia and hypocalcemia lead to clinical symptoms.
- Main causes of hypercalcaemia are primary hyperparathyroidism, malignancy and vitamin D excess.
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Osteoporosis, a decrease in bone density leading to bone fractures, is a major health problem.
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Buckley KA, Fraser WD. Receptor activator for nuclear factor kappaB ligand and osteoprotegrin: regulators of bone physiology and immune responses/potential therapeutic agents and biochemical markers. Ann Clin Biochem 2002;39:551-556.
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Favus MJ, ed. Primer on the metabolic bone disease and disorders of mineral metabolism, 5th ed. Washington DC: American Society for Bone and Mineral Research; 2003.
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Fraser WD. Paget's disease of bone. CPD Rheumatology 2001;2:8-13.
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Fleisch H. Bisphosphonates in bone disease. From the laboratory to the patient, 5th ed. New York, London: The Parthenon Publishing Group; 2001.
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Mundy GR. Bone remodelling and its disorders. 2nd ed. London: Martin Dunitz; 1999.
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Nissenson RA. Parathyroid hormone-related protein. Rev Endocr Metab Disord 2000;1:343-352.
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