Researchers explain history of clinical concept of osteoporosis

The concept of osteoporosis as a preventable, human-centric disease is a relatively new notion with a long formative history, one that a pair of Norwegian recently spelled out in an issue of the journal Science, Technology and Human Values.

Drs. Lidia Santora and John-Arne Skolbekken of the Norwegian University of Science and Technology said that, in 1824, when osteoporosis was first codified as a disease in its own right, it was considered an unavoidable aspect of aging.

At the time, scientists believed that the progressive bone-loss condition was simply a natural part of growing old. Santora and Skolbekken noted that, even 50 years after this initial conceptualization of the disease, the clinical idea of osteoporosis was still rough-hewn and approximate.



For instance, by 1882, German doctors considered it primarily a woman's condition, "something that was attributed to women tripping over their long skirts," the pair wrote.



In 1903, an article published in the now-defunct newspaper The New Zealand Observer and Free Lance described the condition as something contagious and primarily affecting horses.

"Osteoporosis...is now thought to be dying out. The disease was peculiar, drying up the oil and moisture in the bones, thus rendering them brittle and likely to snap at any moment," the article's author ruminated.

Today, scientists know that osteoporosis affects humans of both genders and of practically any age, though the disease is most common among adults who have passed middle age.

More than 34 million Americans are at risk of developing osteoporosis, and another 10 million have been diagnosed with the condition, according to the National Osteoporosis Foundation. Approximately 2 million of those with the disease are men, the organization adds.

However, none of the above facts was clearly understood until the 1930s, when famed U.S. endocrinologist Fuller Albright learned more about osteoporosis while studying in Germany. Upon his return, he and a group of researchers at the Massachusetts General Hospital (MGH) were the first to link the disease to hormones, and specifically to menopause, the Norwegian authors wrote.

It was this discovery - namely, that osteoporosis is connected to hormones and the body's calcium metabolism - that led it to be reframed as a disease, something treatable, rather than as an ineluctable part of aging.

Ultimately, Fulbright classified progressive bone loss as either "postmenopausal" or, for elderly people of both genders, "senile," Santora and Skolbekken said.

These categories have since been expanded upon, but current research into osteoporosis still rests on the pioneering work done at MGH in the 1930s, the pair concluded.
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