Vijayakumar R, Büsselberg D. Osteoporosis: an under-recognized public health problem. J Local Glob Heal Sci. 2016;2:1–13.

Google Scholar 

Dirckx N, Van Hul M, Maes C. Osteoblast recruitment to sites of bone formation in skeletal development, homeostasis, and regeneration. Birth Defects Res Part C - Embryo Today Rev. 2013;99:170–91.

Article  CAS  Google Scholar 

Tanaka H, Minowa K, Satoh T, Koike T. Bone atrophy at high altitude. J Bone Miner Metab. 1992;10:31–6.

Article  Google Scholar 

Terzi R, Yılmaz Z. Bone mineral density and changes in bone metabolism in patients with obstructive sleep apnea syndrome. J Bone Miner Metab. 2016;34:475–81.

Article  PubMed  Google Scholar 

Ma J, Li D, Zhang Z, Li Y, Wang Y, Cao Z. Correlating oxidative stress-related factors with bone metabolic markers in older adult male patients exhibiting degenerative osteoporosis in the high-altitude hypoxic area of China: study protocol for a non-randomized controlled trial. Clin Trials Degener Dis. 2017;2:53–8.

Article  Google Scholar 

Miyauchi Y, Sato Y, Kobayashi T, Yoshida S, Mori T, Kanagawa H, et al. HIF1α is required for osteoclast activation by estrogen deficiency in postmenopausal osteoporosis. Proc Natl Acad Sci U S A. 2013;110:16568–73.

Article  CAS  PubMed  PubMed Central  Google Scholar 

San T, Polat S, Cingi C, Eskiizmir G, Oghan F, Cakir B. Effects of high altitude on sleep and respiratory system and theirs adaptations. Sci World J. 2013;1–7.

Article  Google Scholar 

Singh GK. High altitude dermatology. Indian J Dermatol. 2017;62:59–65.

Article  PubMed  PubMed Central  Google Scholar 

Bouverot P. Adaptation to altitude-hypoxia in vertebrates. In: Heinrich B, Johansen K, Langer H, Neuweile G, Randall DJ, editors. New York: Springer-Verlag Berlin; 1985. 1st ed, pp. 1–18

Brown JPR, Grocott MPW. Humans at altitude: physiology and pathophysiology. Contin Educ Anaesthesia Crit Care Pain. 2013;13:17–22.

Article  Google Scholar 

Beretta E, Lanfranconi F, Grasso GS, Bartesaghi M, Alemayehu HK, Pratali L, et al. Air blood barrier phenotype correlates with alveolo-capillary O2 equilibration in hypobaric hypoxia. Respir Physiol Neurobiol. 2017;246:53–8.

Article  PubMed  Google Scholar 

Hinkelbein J, Jansen S, Iovino I, Kruse S, Meyer M, Cirillo F, et al. Thirty minutes of hypobaric hypoxia provokes alterations of immune response, haemostasis, and metabolism proteins in human serum. Int J Mol Sci. 2017;18:1–9.

Article  Google Scholar 

Kylhammar D, Rådegran G. The principal pathways involved in the in vivo modulation of hypoxic pulmonary vasoconstriction, pulmonary arterial remodelling and pulmonary hypertension. Acta Physiol. 2017;219:728–56.

Article  CAS  Google Scholar 

Leali PT, Muresu F, Melis A, Ruggiu A, Zachos A, Doria C. Skeletal fragility definition. Clin Cases Miner Bone Metab. 2011;8:11–3.

PubMed  PubMed Central  Google Scholar 

Verratti V, Ietta F, Paulesu L, Romagnoli R, Ceccarelli I, Doria C, et al. Physiological effects of high-altitude trekking on gonadal, thyroid hormones and macrophage migration inhibitory factor (MIF) responses in young lowlander women. Physiol Rep. 2017;5:1–9.

Article  Google Scholar 

Verratti V, Falone S, Fanò G, Paoli A, Reggiani C, Tenaglia R, et al. Effects of hypoxia on nocturnal erection quality: a case report from the Manaslu Expedition. J Sex Med. 2011;8:2386–90.

Article  PubMed  Google Scholar 

West JB. High-altitude medicine. Am J Respir Crit Care Med. 2012;186:1229–37.

Article  PubMed  Google Scholar 

Dunwoodie SL. The role of hypoxia in development of the mammalian embryo. Dev Cell. 2009;17:755–73.

Article  CAS  PubMed  Google Scholar 

Crockett JC, Rogers MJ, Coxon FP, Hocking LJ, Helfrich MH. Bone remodelling at a glance. J Cell Sci. 2011;124:991–8.

Article  CAS  PubMed  Google Scholar 

An SY, Heo JS. Low oxygen tension modulates the osteogenic differentiation of mouse embryonic stem cells. Tissue Cell. 2018;52:9–16.

Article  CAS  PubMed  Google Scholar 

Yellowley CE, Genetos DC. Hypoxia signaling in the skeleton: implications for bone health. Curr Osteoporos Rep. 2019;17:26–35.

Article  PubMed  PubMed Central  Google Scholar 

Basu M, Malhotra AS, Pal K, Kumar R, Bajaj R, Verma SK, et al. Alterations in different indices of skeletal health after prolonged residency at high altitude. High Alt Med Biol. 2014;15:170–5.

Article  CAS  PubMed  Google Scholar 

Bhattarai HK, Shrestha S, Rokka K, Shakya R. Vitamin D, calcium, parathyroid hormone, and sex steroids in bone health and effects of aging. J Osteoporos. 2020;1–10.

Article  Google Scholar 

Basu M, Malhotra AS, Pal K, Chatterjee T, Ghosh D, Haldar K, et al. Determination of bone mass using multisite quantitative ultrasound and biochemical markers of bone turnover during residency at extreme altitude: a longitudinal study. High Alt Med Biol. 2013;14:150–4.

Article  CAS  PubMed  Google Scholar 

Osterhoff G, Morgan EF, Shefelbine SJ, Karim L, McNamara LM, Augat P. Bone mechanical properties and changes with osteoporosis. Injury. 2016;47:11–20.

Article  Google Scholar 

Chatterjee T, Bhattacharyya D, Pramanik A, Pal M, Majumdar DD, Majumdar DD. Soldiers’ load carriage performance in high mountains: a physiological study. Mil Med Res. 2017;4:1–9.

Google Scholar 

Hadjidakis DJ, Androulakis II. Bone remodeling. Ann NY Acad Sci. 2006;396:385–96.

Article  Google Scholar 

Grabowski P. Physiology of bone. Endocr Dev. 2009;28:32–48.

Article  Google Scholar 

Florencio-silva R, Da Sasso GRS, Sasso-cerri E, Simões MJ, Cerri PS, Rodrigues G. Biology of bone tissue: structure, function, and factors that influence bone cells. Biomed Res Int. 2015;1–17.

Article  Google Scholar 

Kronenberg HM. Developmental regulation of the growth plate. Nature. 2003;423:332–6.

Article  CAS  PubMed  Google Scholar 

Gunson D, Gropp KE, Varela A. Bone and joints. Fundam Toxicol Pathol Third Ed Elsevier Inc. 2018.

Wang J, Zhou J, Cheng CM, Kopchick JJ, Bondy CA. Evidence supporting dual, IGF-I-independent and IGF-I-dependent, roles for GH in promoting longitudinal bone growth. J Endocrinol. 2004;180:247–55.

Article  CAS  PubMed  Google Scholar 

Kim CH, Takai E, Zhou H, Von Stechow D, Müller R, Dempster DW, et al. Trabecular bone response to mechanical and parathyroid hormone stimulation: the role of mechanical microenvironment. J Bone Miner Res. 2003;18:2116–25.

Article  CAS  PubMed  Google Scholar 

Chapuy MC, Arlot ME, Duboef F, Brun J, Crouzet B, Arnaud S, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;327:1637–42.

Article  CAS  PubMed  Google Scholar 

Weinstein RS, Jilka RL, Michael Parfitt A, Manolagas SC. Inhibition of osteoblastogenesis and promotion of apoptosis of osteoblasts end osteocytes by glucocorticoids potential mechanisms of their deleterious effects on bone. J Clin Invest. 1998;102:274–82.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Armstrong VJ, Muzylak M, Sunters A, Zaman G, Saxon LK, Price JS, et al. Wnt/β-catenin signaling is a component of osteoblastic bone cell early responses to load-bearing and requires estrogen receptor α. J Biol Chem. 2007;282:20715–27.

Article  CAS  PubMed  Google Scholar 

Stegen S, Carmeliet G. The skeletal vascular system – breathing life into bone tissue. Bone. 2018;115:50–8.

Article  CAS  PubMed  Google Scholar 

Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, et al. Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int. 1999;10:259–64.

Article  CAS  PubMed  Google Scholar 

Kanis J, Melton L, Christiansen C, Johnston C, Khaltaev N. The diagnosis of osteoporosis. J Korean Med Assoc. 1994;9:1137–41.

CAS  Google Scholar 

Kaushal N, Vohora D, Jalali RK, Jha S. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population - a cross-sectional retrospective study. Osteoporos Sarcopenia. 2018;4:53–60.

Article  PubMed  PubMed Central  Google Scholar 

Mithal A, Kaur P. Osteoporosis in Asia : a call to action. Curr Osteoporos Rep. 2012;10:245–7.

Article  PubMed  Google Scholar 

Vaidya R, Shah R. Bone mineral density and reference standards for Indian women. J Midlife Health. 2010;1:55.

PubMed  PubMed Central  Google Scholar 

Malhotra N, Mithal A. Osteoporosis in Indians. Indian journl Med Res. 2015;263–8.

Mithal A, Bansal B, Kyer SC, Ebeling P. The Asia-Pacific Regional Audit-Epidemiology, costs, and burden of osteoporosis in India 2013: a report of International Osteoporosis Foundation. Indian J Endocrinol Metab. 2014;18:449–54.

Article  PubMed  PubMed Central  Google Scholar 

Shatrugna V, Kulkarni B, Kumar PA, Balakrishna N, Rani US. Bone status of Indian women from a low-income group and its relationship to the nutritional status. Osteoporos Sarcopenia. 2005;16:1827–35.

Article