[Updates on Lifestyle-Related Diseases and Bone Metabolism. Efficacy of selective estrogen receptor modulators (SERMs) in lifestyle-related osteoporosis].

Most of the evidence for osteoporosis treatment comes from that in primary osteoporosis, with very little evidence available for that in secondary osteoporosis including lifestyle-related osteoporosis as a lifestyle-related disease despite the fact that secondary osteoporosis affects more patients than primary osteoporosis. This is in contrast to osteoporosis associated with type 2 diabetes and chronic kidney disease, where accumulating evidence demonstrates that osteoporosis is accounted for by decreases in bone strength associated with deterioration of bone quality due to accumulation of advanced glycation end products (AGEs) in collagen that results from elevated homocysteine and pentosidine levels. In this regard, given the ample evidence for their efficacy against deterioration of bone quality, selective estrogen receptor modulators (SERMs) are currently thought to represent the most efficacious of all available therapeutic agents for lifestyle-related osteoporosis.