MT16 QSU60104 M221 | TASK: MUSCLE AND BONE PROBLEMS

NAME:
MATRIC NO:

Instruction: Answer all questions in this paper

(1) Osteoporosis

a) Give definition of osteoporosis

Osteoporosis (OP) is acknowledged as a serious public health problem as it is

associated with substantial physical and economic burdens affecting more than
200 million people worldwide (M. De Martinis, M. M. Sirufo, and G. O.
Lia.2020). Osteoporosis occurs due to an imbalance between bone resorption
and bone formation. As a result, bone breakdown exceeds bone formation.
(Noh, Ji-Yoon, Young Yang, and Haiyoung Jung. 2020). Osteoporosis is a bone
disease that develops when bone mineral density and bone mass decreases,
or when the quality or structure of bone changes. This can lead to a decrease
in bone strength that can increase the risk of fractures (broken bones). You
may not even know you have the disease until you break a bone because
osteoporosis is a “silent” disease which typically do not have symptoms.
Osteoporosis is the major cause of fractures in postmenopausal women and in
older men.

b) Give four (4) risk factors that can contribute to osteoporosis

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Figure 1. Risk factors for osteoporosis. Risk factors can cause an imbalance in the remodeling
process leading to osteoporosis.

There are factors associated with an increased risk of osteoporosis-related

fractures. These include general factors that relate to aging and sex steroid
deficiency, as well as specific risk factors such as use of glucocorticoids (which
cause decreased bone formation and bone loss), reduced bone quality, and
disruption of microarchitectural integrity. Fractures result when weakened bone
is overloaded, often by falls or certain daily chores. (Riggs BL, Wahner HW,
Seeman E, Offord KP, Dunn WL, Mazess RB, et al.1982)

 Age: Risk increases after the mid-30s and especially after menopause. As you
age, bone loss happens more quickly, and new bone growth is slower. Over
time, your bones can weaken and your risk for osteoporosis increases.

 Changes to hormones / Reduced sex hormones:

Low levels of certain hormones can increase your chances of developing

osteoporosis.

- Lower estrogen levels appear to make it harder for bone to regenerate.

- Low estrogen levels in women after menopause. Low levels of estrogen
from the abnormal absence of menstrual periods in premenopausal
women due to hormone disorders or extreme levels of physical activity.
- Low levels of testosterone in men. Men with conditions that cause low
testosterone are at risk for osteoporosis.

 Ethnicity: White people and Asian people have a higher risk than other ethnic
groups. African American and Mexican American women have a lower risk.
White men are at higher risk than African American and Mexican American
men.

 Height and weight: Being over 5 feet 7 inches tall or weighing under 125
pounds increases the risk. Slender, thin-boned women and men are at greater
risk to develop osteoporosis because they have less bone to lose compared to
larger boned women and men.
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c) In old aged woman, how the hormonal changes may increase the risks factor
for getting osteoporosis?

Hormones, such as estrogen, testosterone, and parathyroid hormone (PTH),

play a significant role in bone remodeling by inhibiting bone breakdown and
promoting bone formation. Estrogen is a key part of metabolism. It promotes
the activity of osteoblasts, which are cells that make bone. (Megan Soliman,
MD,2020)
The peak bone mass is reached at the age of 25–30 years in women.
The reduced production of estrogen in postmenopausal women induces
substantial bone loss. When a person has low levels of estrogen, they have an
increased risk of osteoporosis and fractures. Hence, women are more at risk of
developing osteoporosis than men because the hormone changes that happen
at the menopause directly affect bone density. The female hormone oestrogen
is essential for healthy bones.

Whereas bone loss is accelerated during the perimenopausal period, the

rate of bone loss decreases several years after menopause. After the
menopause, oestrogen levels fall. This can lead to a rapid decrease in bone
density. Thus, due to age-related hormonal changes, women with the age of 60
years and are at risk of developing osteoporosis （Raisz, L.G. Pathogenesis of
osteoporosis. 2005）.

d) Is it osteoporosis can be reversed? If Yes (please explain), if No (please

suggest how people can maintain the bone health.

Skeletal remodeling is the result of both bone resorption and bone formation. In
cases in which the rate of bone resorption is increased, there could be no
apparent bone loss if the rate of bone formation is matched, since the bone
removed will be replaced by new bone formation. Osteoporosis is, thus, an
imbalance condition where the rate of bone resorption is higher than the one of
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bone formation, resulting in continuous loss of bone and deterioration of

skeletal microarchitecture.

Osteoblasts are mononucleate cells which are responsible for bone formation.
During ossification, or bone forming, osteoblasts produce an unmineralized,
organic portion of the bone matrix known as osteoid. The osteoids produced
will then mineralize, with minerals such as calcium and zinc, to form new bone
tissue.

Doctors may use stem cell therapy to treat osteoporosis in the future. In

2016, researchers foundTrusted Source that injecting a particular kind of
stem cell into mice reversed osteoporosis and bone loss in a way that could
also benefit humans.

Scientists believe that genetic factors strongly determine bone density.

Researchers are investigating which genes are responsible for bone
formation and loss in the hope that this might offer new osteoporosis
treatment in the future.

(2) Muscle Athrophy

a) What is muscle atrophy?

Muscle function is influenced by different quality systems that regulate the

function of contractile proteins and organelles. Cardiac muscle cells are
peculiar because the cytoplasm is filled by contractile proteins that are
surrounded by organelles. This organized structure implies that protein and
organelle turnover have a major impact on myofiber size and function.
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Whereas, Catabolic conditions such as cancer, infections, diabetes, organ

failure, or inactivity/disuse promote a net loss of proteins, organelles, and
cytoplasm causing shrinkage of the cellular volume, a condition named atrophy.

Hence, muscle atrophy is the wasting or thinning of muscle mass. It’s usually
caused by a lack of physical activity. It can be caused by disuse of your
muscles or neurogenic conditions. Symptoms include a decrease in muscle
mass, one limb being smaller than the other, and numbness, weakness and
tingling in your limbs.

When a disease or injury makes it difficult or impossible for you to move an arm
or leg, the lack of mobility can result in muscle wasting. Over time, without
regular movement, your arm or leg can start to appear smaller but not shorter
than the one you’re able to move. Elaine K. Luo, M.D.（2019）

b) How muscle atrophy can occur in athlete?

Muscular atrophy regularly occurs as a consequence of immobilisation or

disuse after sports injuries. (H J Appell. Sports Med. 1990)

c) Suggest two (2) exercises that can improve muscle atrophy.

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Refences

Delgado, B. J., et al. (2022). Estrogen.retrieved at:

https://www.ncbi.nlm.nih.gov/books/NBK538260/

Harper-Harrison, G., et al. (2022). Hormone replacement therapy.

retrieved at: https://www.ncbi.nlm.nih.gov/books/NBK493191/

A. Howard. (2011) . Coding for bone diseases . For The Record, vol. 23, no.
9, p. 27.

O. Rutherford (1990). The role of exercise in prevention of osteoporosis,”

Physiotherapy, vol. 76, pp. 522–526