Book Review

Disorders of Bone and Mineral Metabolism

N Engl J Med 1993; 328:1649June 3, 1993

Article

Disorders of Bone and Mineral Metabolism
Edited by Fredric L. Coe and Murray J. Favus. 1118 pp., illustrated. New York, Raven Press, 1992. $195. ISBN: 0-88167-749-3

This book is dedicated, appropriately, to Dr. Fuller Albright, a pioneer endocrinologist whose observations on the cause and physiology of metabolic bone disease earlier this century opened the field to intensive research for the next 40 years. The results of these investigations are now available in Disorders of Bone and Mineral Metabolism. The organization and writing of this book have some of the distinctive flavor of Albright and Reifenstein's Parathyroid Glands and Metabolic Bone Disease (Baltimore: Williams and Wilkins, 1948). In spite of its numerous authors (71), the book has a consistent and orderly style. This is a tome (1118 pages), and the references are remarkably complete. Illustrative of the exhaustive and fine detail is the chapter entitled “Renal Handling of Calcium and Phosphorus.” Not a point has been missed, and the authors cite 454 references.

The book is divided into seven sections; the first four are “Normal Mineral Metabolism,” “Bone Structure and Biology,” “Mineral Metabolism during the Human Life Cycle,” and “Introduction to Clinical Mineral Disorders.” There is a logical flow to these sections: they begin with the physiology of calcium, phosphorus, and magnesium and their major hormone regulators, vitamin D and parathyroid hormone. The next section, on bone structure and biology, could, by itself, be a textbook on the complex mechanism of bone composition and remodeling. The third section, on mineral metabolism during the human life cycle, is interesting and provides a background for the interpretation of disorders of mineral metabolism. The fourth section, which I enjoyed very much, details the important methods of measuring histologic changes in bone and the interpretation of bone biopsies. These four sections, read sequentially, provide an enormous amount of information. Clearly, they are designed more for researchers than for general endocrinologists.

The last three sections are superb, especially that on disorders of bone. The writing in some of the chapters is reminiscent of Fuller Albright at his descriptive and reasoning best. For one who, like me, remembers Albright's keen intellect, fond memories are kindled by reading the section on renal calculi, which explains not only the physical chemistry of stone formation and its many causes, including a fine discussion of the role of nephrocalcin, but also newer modes of therapy, including lithotripsy.

I was most impressed by this textbook. It should be of great interest to all endocrinologists, especially those interested in this field of research. Having read other textbooks on mineral metabolism and bone disease over the years, I can say that not one has been as enjoyable, as complete, as up to date, or as well written and edited.

Daniel S. Bernstein, M.D.
Boston University School of Medicine, Boston, MA 02118