Osteoporosis

Osteoporosis is a disease of bone in which bone mineral density is reduced and bone microarchitecture is disrupted. Osteoporotic bones are susceptible to fracture. It is defined according to the bone mineral density (BMD) as measured by DEXA: a BMD of 2.5 standard deviations below the peak bone mass (20-year-old person standard) is considered osteoporosis. While treatment modalities are becoming available, prevention is still the most important way to reduce fracture. Due to its hormonal component, more women suffer from osteoporosis than men.

Etiology

Estrogen deficiency following menopause causes a rapid reduction in BMD. This, plus the increased risk of falling associated with aging, leads to fractures of the wrist, spine and hip. Other hormone deficiency states can lead to osteoporosis, such as testosterone deficiency. Glucocorticoid or thyroxine excess states also lead to osteoporosis. Lastly, calcium and/or vitamin D deficiency from malnutrition increases the risk of osteoporosis.

Related Topics:
Estrogen - Menopause - Hormone - Testosterone - Glucocorticoid - Thyroxine - Calcium - Vitamin D

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List of disorders associated with osteoporosis:

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• Hypogonadal states - Turner syndrome, Klinefelter syndrome, anorexia nervosa, hypothalamic amenorrhea, hyperprolactinemia.
• Endocrine disorders - Cushing's syndrome, hyperparathyroidism, thyrotoxicosis, insulin-dependent diabetes mellitus, acromegaly, adrenal insufficiency
• Nutritional and gastrointestinal disorders - malnutrition, parenteral nutrition, malabsorption syndromes, gastrectomy, severe liver disease (especially biliary cirrhosis), pernicious anemia.
• Rheumatologic disorders - rheumatoid arthritis, ankylosing spondylitis
• Hematologic disorders/malignancy - multiple myeloma, lymphoma and leukemia, mastocytosis, hemophilia, thalassemia.
• Inherited disorders - osteogenesis imperfecta, Marfan syndrome, hemochromatosis, hypophosphatasia, glycogen storage diseases, homocystinuria, Ehlers-Danlos syndrome, porphyria, Menkes' syndrome, epidermolysis bullosa.
• Iatrogenic osteoporosis, caused by the therapeutic use of glucocorticoids.
• Other disorders - immobilization, chronic obstructive pulmonary disease, pregnancy and lactation, scoliosis, multiple sclerosis, sarcoidosis, amyloidosis