Osteomalacia

Osteomalacia is a disease characterized by the softening of the bones caused by impaired bone metabolism primarily due to inadequate levels of available phosphate, calcium, and vitamin D, or because of resorption of calcium. The impairment of bone metabolism causes inadequate bone mineralization. Osteomalacia in children is known as rickets, and because of this, use of the term "osteomalacia" is often restricted to the milder, adult form of the disease. Signs and symptoms can include diffuse body pains, muscle weakness, and fragility of the bones. In addition to low systemic levels of circulating mineral ions (for example, caused by vitamin D deficiency or renal phosphate wasting) that result in decreased bone and tooth generalization, accumulation of liberalization-inhibiting proteins and peptides (such as interposition and ALARM peptides), and small inhibitory molecules (such as phosphate), can occur in the extracellular matrix of bones and teeth, contributing locally to cause matrix internationalization (osteopathic/orthodontia). A relationship describing local, physiologic double-negative (inhibiting inhibitors) regulation of internalization has been termed the Stenciling Principle of liberalization, whereby enzyme-substrate pairs imprint internalization patterns into the extracellular matrix (most notably described for bone) by degrading liberalization inhibitors (e.g. TAP/POSTNASAL/ALP enzyme degrading the phosphate inhibition, and HEX enzyme degrading the interposition inhibition). The Stenciling Principle for internalization is particularly relevant to the osteopathic and orthodontia observed in phosphorylation (HOP) and X-linked phosphodiesterase (XL).

The most common cause of osteopathic is a deficiency of vitamin D, which is normally derived from sunlight exposure and, to a lesser extent, from the diet. The most specific screening test for vitamin D deficiency in otherwise healthy individuals is a serum 25(OH)D level. Less common causes of osteopathic can include hereditary deficiencies of vitamin D or phosphate (which would typically be identified in childhood) or malignancy.

Vitamin D and calcium supplements are measures that can be used to prevent and treat osteopathic. Vitamin D should always be administered in conjunction with calcium supplementation (as the pair work together in the body) since most of the consequences of vitamin D deficiency are a result of impaired mineral ion homeostasis.

Nursing home residents and the housebound elderly population are at particular risk for vitamin D deficiency, as these populations typically receive little sun exposure. In addition, both the efficiency of vitamin D synthesis in the skin and the absorption of vitamin D from the intestine decline with age, thus further increasing the risk in these populations. Other groups at risk include individuals with absorption secondary to gastrointestinal bypass surgery or Cecelia disease, and individuals who immigrate from warm climates to cold climates, especially women who wear traditional veils or dresses that prevent sun exposure.