Table of Contents

Preface to the Fourth Edition


Editor’s Note

Part I: Introduction

Chapter 1. The Bone Organ System: Form and Function


Composition and Organization of Bone

Cellular Components of Bone

Bone Homeostasis

Basic Bone Mechanics



Chapter 2. The Nature of Osteoporosis

Defining Osteoporosis

Material and Structural Basis of Skeletal Fragility



Chapter 3. Reflections on Osteoporosis




Fragility Fractures

Bone Density and Fracture Risk






Chapter 4. Reflections on Development of Concepts of Intercellular Communication in Bone


Calcium Homeostasis – Developments of the 1960s

Discovery of Calcitonin

Inhibition of Bone Resorption by Calcitonin

Lessons from an Osteogenic Sarcoma

Emergence of Bone Cell Biology

Could Osteoblasts Regulate Osteoclasts?

The Origin of Osteoclasts – Mid-1970s

Osteoblast Regulation of Osteoclasts

Control of Osteoclast Formation

Hormone and Cytokine Control of Osteoclast Formation

The Physiologic Signaling Mechanisms in Osteoclast Control

Bone Remodeling

Coupling of Bone Formation to Resorption

Coupling Factor – from Matrix or Cells?

Communication from Osteocytes

Is There a Single “Coupling Factor”, Analogous to RANKL?

PTHrP as a Local Control Process

How Might PTHrP Participate?




Chapter 5. Osteo-Odyssey: A Memoir

Starting Out: From A to B One

Being the First Postdoc in Larry’s Lab

In the Academic World:


No. of pages:
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Academic Press
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About the authors

David Dempster

David W. Dempster, PhD, is Professor of Clinical Pathology and Cell Biology at Columbia University in New York. He obtained his PhD from the University of Glasgow in Scotland and completed postdoctoral studies in Switzerland and France. Dr. Dempster is a Past President of the International Society of Bone Morphometry and a member of the Scientific Advisory Council of the National Osteoporosis Foundation. He is also a Fellow of the Royal Microscopical Society. Dr. Dempster’s iconic micrographs of osteoporotic bone have been widely reproduced in the scientific and popular press, including being displayed at the Smithsonian Institution in Washington, DC. Dr. Dempster is an Associate Editor of Osteoporosis International, and serves on the editorial boards of the Journal of Bone and Mineral Research, Bone and the Journal of Clinical Densitometry. His research studies have been continuously supported by the National Institutes of Health for the past 25 years. Dr. Dempster has published over 200 research papers on the pathophysiology and treatment of bone disese.

Affiliations and Expertise

Professor of Clinical Pathology, Columbia University School of Medicine; Director, Regional Bone Center, Helen Hayes Hospital, New York, NY, USA

Marjorie Luckey

Marjorie M. Luckey, MD is Medical Director of the Osteoporosis and Metabolic Bone Disease Center at the Saint Barnabas Medical Center in Livingston, NJ. She holds board certifications in Internal Medicine and Endocrinology and Metabolism and has been actively engaged in bone disease research, education, and patient care since 1982. As Associate Professor of Reproductive Science at Mount Sinai Medical Center in New York, New York, her independent research and publications included NIH-supported studies of bone health and calcium metabolism in African-American women; studies on the effects of organ transplantation, genetic diseases, and primary biliary cirrhosis on bone health; and investigations into laboratory testing in osteoporotic women. In addition, she has participated in many multinational trials of new therapeutic agents for osteoporosis. Dr. Luckey is Chair of the Better Bones Project, a national education program designed to teach primary care physicians how to evaluate and treat osteoporosis. She is on the editorial board of the Journal of Clinical Densitometry, on the Scientific Advisory Council of the National Osteoporosis Foundation and is a member of the Bone Densitometry Certification Faculty for the International Society for Clinical Densitometry. She has also served on the Board of Directors of the International Society for Clinical Densitometry, the Practice Committee for The American Society of Bone and Mineral Research, and the National Bone Health Campaign Scientific Task Force for the Centers for Disease Control and Prevention.

Affiliations and Expertise

Associate Professor of Reproductive Science, Mount Sinai Medical Center, New York, NY; Medical Director, Osteoporosis and Metabolic Bone Disease Center, Saint Barnabas Health Care System, Livingston, NJ, USA

Jane Cauley

Dr. Cauley is Professor and Vice Chair for Research, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh (Pennsylvania). Her primary research interest is the epidemiology of osteoporosis, osteoporosis treatment and the consequences of osteoporosis in both men and women. She also has a major interest in menopause and the multiple physiological, social, pathological changes that occur during this time. Her research has focused on women's health and aging, falls, the interaction between endogenous and exogenous hormones, risk factors, inflammation, and disease outcomes. Her work has focused on use of hormone therapy, osteoporosis, risk of hip fractures and bone density in midlife women to older women. She is the Principal Investigator (PI) of several large cohort studies including the Study of Osteoporotic Fracture (SOF) and the Osteoporotic Fracture Risk in Men Study (MrOS). Results from both of these studies have made major improvements in our understanding of osteoporosis in older men and women. Dr. Cauley was Co-PI for the Women's Health Initiative (WHI) and served as study wide Chair of the Osteoporosis, Calcium and Vitamin D Committee for almost the entire duration of the trial. She is a Co-investigator for the Study of Women's Health Across the Nation (SWAN) with particular emphases on skeletal health and physical function and body composition changes as women transition from midlife to elder status. She is also a PI of a SWAN ancillary study examining novel measures of hip strength. She has participated as a clinical center PI for major randomized clinical trials including the Fracture Intervention Trial, the Multiple Outcomes of Raloxifene Evaluation, the Heart Estrogen/Progestin Study, the HORIZON Pivotal Fracture Trial and the Testosterone Trial. She has published over 570 original research articles.

Affiliations and Expertise

Professor of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA