Which of the following best describes the pathophysiological mechanism of osteoporosis?
Group of answer choices
- Increased bone formation due to excessive activity of osteoblasts
- Autoimmune attack on bone marrow cells
- Abnormal deposition of collagen fibers in bone
- Reduced bone mass due to increased osteoclast activity and decreased bone formation
The correct answer is:
Reduced bone mass due to increased osteoclast activity and decreased bone formation
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Explanation:
Osteoporosis is characterized by low bone mass and microarchitectural deterioration, leading to fragility fractures. Its pathophysiology involves:
- Increased osteoclast activity: Excessive bone resorption.
- Decreased osteoblast activity: Reduced bone formation (often due to aging, estrogen deficiency, or calcium/vitamin D insufficiency).
- Imbalance in bone remodeling: Resorption outpaces formation.
Why Not the Others?
- Increased bone formation (osteoblast activity): Occurs in Paget’s disease, not osteoporosis.
- Autoimmune attack on bone marrow: Seen in multiple myeloma or rheumatoid arthritis, not osteoporosis.
- Abnormal collagen deposition: Occurs in osteogenesis imperfecta (brittle bone disease), not typical osteoporosis.
Key Risk Factors:
- Postmenopausal women (estrogen loss → ↑ osteoclasts).
- Aging (↓ osteoblast function).
- Glucocorticoid use (↓ bone formation).
Thus, osteoclast-driven bone loss is the core mechanism.
