Series Editor
Romesh K Khardori MD PhD FACP FRCP(C)
Professor Division of Endocrinology, Diabetes and Metabolism Department of Internal Medicine Eastern Virginia Medical School Consultant EVMS Strelitz Center for Diabetes Endocrine and Metabolic Disorders
Norfolk, Virginia, USA
Editor
Subhash C Kukreja MD
Professor of Medicine and Chief of Endocrinology, Diabetes and Metabolism University of Illinois College of Medicine
Chicago, Illinois, USA
Associate Editor
Sanjay K Bhadada MD DM MNAMS FICP FRCPI FNAMS
Professor Department of Endocrinology Postgraduate Institute of Medical Education and Research
Chandigarh, India
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Clinical Focus Series
Bone and Mineral Disorders / Romesh K Khardori, Subhash C Kukreja
Cover images: Vitamin D deficiency osteomalacia. Before (left) and after (right) treatment with vitamin D. Courtesy: Dr Sudhaker Rao.
First Edition: 2020
9789352704781
Printed at
fm5Dedication
Dedicated to our students who teach
fm7Contributors
SERIES EDITOR
- Romesh K Khardori MD PhD FACP FRCP(C)
- Professor
- Division of Endocrinology, Diabetes and Metabolism
- Department of Internal Medicine
- Eastern Virginia Medical School
- Consultant
- EVMS Strelitz Center for Diabetes
- Endocrine and Metabolic Disorders
- Norfolk, Virginia, USA
EDITOR
- Subhash C Kukreja MD
- Professor of Medicine and
- Chief of Endocrinology, Diabetes and Metabolism
- University of Illinois
- College of Medicine
- Chicago, Illinois, USA
ASSOCIATE EDITOR
- Sanjay K Bhadada MD DM MNAMS FICP FRCPI FNAMS
- Professor
- Department of Endocrinology
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
CONTRIBUTING AUTHORS
- Ambrish Mithal MD DM
- Chairman, Head of the Department
- Division of Endocrinology and Diabetes
- Medanta - The Medicity
- Gurugram, Haryana, India
- Chaitanya Mamillapalli MD MRCP
- Department of Endocrinology
- Consultant Endocrinologist
- Springfield Clinic
- Elena Barengolts MD
- Professor of Medicine, University of Illinois
- Chief, Section of Endocrinology,
- Jesse Brown VA Medical Center
- MP 111, 820 S Damen Ave
- Chicago, Illinois, USA
- Leonid Vydro MD
- Endocrinologist
- Abrazo Medical Group
- United States
- Mohammad S Kuchay MD DM
- Consultant
- Division of Endocrinology and Diabetes
- Medanta - The Medicity
- Gurugram, Haryana, India
- Priyanka Singh PhD
- Scholar, Department of Endocrinology
- Postgraduate Institute of
- Medical Education and Research
- Chandigarh, India
- Rekha Singh MD DM
- Associate Professor
- Department of Endocrinology and Metabolism
- All India Institute of Medical Sciences
- Bhopal, Madhya Pradesh, India
- Shabna Sulaiman MD
- Senior Resident
- Department of Nephrology
- Postgraduate Institute of
- Medical Education and Research
- Chandigarh, India
- Soham Mukherjee DM
- Consultant Endocrinologist
- Ojas Hospital
- Panchkula, Haryana, India
- Sudhaker D Rao MBBS FACP FACE
- Director
- Bone and Mineral Research
- Laboratory, HFHS
- Detroit, USA
- Sushil K Gupta MD DM DNB
- Professor
- Department of Endocrinology
- Sanjay Gandhi Postgraduate Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Yuval Eisenberg MD
- Assistant Professor
- Department of Medicine
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois
- Chicago, Illinois, USA
The new knowledge in the field of bone and mineral metabolism and bone disorders has expanded vastly in the past 25 years. Discovery of novel mechanisms involved in bone resorption through osteoclasts and bone formation through osteoblasts, has allowed the development of effective therapeutic agents for osteoporosis, resulting in reduction of fracture risk and reduced mortality. We now understand the critical role played by the osteocytes (previously thought to be inactive resting cells) in regulating calcium and phosphorus metabolism and in the regulation of bone cell functions through autocrine, paracrine and endocrine mechanisms. These observations have led to the discovery of potential anabolic therapeutic agents for osteoporosis and novel compounds for treating disorders of phosphorus metabolism. Adequate levels of various nutrients (calcium, phosphorus, vitamin D and others) are important for optimal bone health and health in general. It has been clear that deficiency of these nutrients leads to disease states. We now have a better understanding of the optimal levels of these nutrients for normal individuals or on the potential risks of excessive intake.
We are grateful to various authors for taking time out of their busy lives to assemble this monograph on current state of knowledge in the field. We know that this information could become outdated as new discoveries are made. However, we are confident that the information in this book will provide a strong basis for basic understanding of bone and mineral physiology and treatment for disease states.
Subhash C Kukreja