Importance of tailor-made treatment for primary osteoporosis : Evaluation based on measurements of bone density and bone quality.

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Biochemical markers of bone quality following administration of different pharmacological agents were measured in a rabbit hyperhomocysteinemia model(an experimental model of reduced human bone quality) developed in our laboratory. The results clearly indicated, similarly to our previously reported findings on human reduced-bone-quality-type osteoporosis that by incurring direct detrimental changes on collagen coss-links homocysteine reduces bone strength ; this mechanism is independent of reduction in bone density.Additionally, based on findings that estrogen receptor modulators are more effective in patients with reduced-bone-quality-type osteoporosis, we suggest subdividing patients accordingly with the type of osteoporosis upon diagnosis and treatment of the disease.