Osteoporosis risk factors: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
(40 intermediate revisions by 7 users not shown) | |||
Line 1: | Line 1: | ||
__NOTOC__ | |||
{{Osteoporosis}} | {{Osteoporosis}} | ||
{{CMG}} | {{CMG}}; {{AE}}{{EG}} | ||
==Overview== | ==Overview== | ||
Risk factors for [[ | Risk factors for [[osteoporosis]] [[disease]] are of two types, including non-modifiable and modifiable (potentially) factors. Non-modifiable risk factors include age, sex, [[menopause]], and [[family history]]. Modifiable (potentially) risk factors include [[smoking]], [[Alcohol|alcohol consumption]], [[immobility]], [[glucocorticoid]] abuse, and use of [[Proton pump inhibitor|proton pump inhibitor (PPI)]]. | ||
==Risk factors for osteoporosis disease== | |||
===Common risk factors=== | |||
* Age > 50 | |||
* [[Menopause]] (lack of [[estrogen]]) | |||
* [[Family history (medicine)|Family history]] of [[Bone fracture|fracture]] or [[osteoporosis]] | |||
* History of at least two [[Bone fracture|fractures]]<ref>{{cite journal |author=Ojo F, Al Snih S, Ray LA, Raji MA, Markides KS |title=History of fractures as predictor of subsequent hip and nonhip fractures among older Mexican Americans |journal=Journal of the National Medical Association |volume=99 |issue=4 |pages=412-8 |year=2007 |pmid=17444431 |doi=}}</ref> | |||
* [[Alcohol]] consumption | |||
* [[Smoking]] (inhibits activity of [[osteoblasts]])<ref>{{cite journal |author=Wong PK, Christie JJ, Wark JD |title=The effects of smoking on bone health |journal=Clin. Sci. |volume=113 |issue=5|pages=233–41 |year=2007 |pmid=17663660 |doi=10.1042/CS20060173}}</ref> | |||
* Insufficient [[physical activity]] (lack of [[bone]] remodeling) | |||
* [[Glucocorticoids]] ([[steroid]]-induced [[osteoporosis]])<ref>{{cite book |author=Bone and Tooth Society of Great Britain, National Osteoporosis Society, Royal College of Physicians |title=Glucocorticoid-induced Osteoporosis |year=2003 |publisher=Royal College of Physicians of London |location=London, UK |isbn=1-860-16173-1 | url=http://www.rcplondon.ac.uk/pubs/contents/966c62dd-8011-4f65-a61d-dd0c7fe4fa4b.pdf }}</ref> | |||
* [[Proton pump inhibitors]]<ref name="pmid17190895">{{cite journal |vauthors=Yang YX, Lewis JD, Epstein S, Metz DC |title=Long-term proton pump inhibitor therapy and risk of hip fracture |journal=JAMA |volume=296 |issue=24 |pages=2947–53 |year=2006 |pmid=17190895 |doi=10.1001/jama.296.24.2947 |url=}}</ref> | |||
===Less common risk factors=== | |||
* Low [[body mass index]] (BMI): being [[overweight]] protects against [[osteoporosis]], either by increasing load or through the [[leptin]] [[hormone]]<ref>{{cite journal |author=Shapses SA, Riedt CS |title=Bone, body weight, and weight reduction: what are the concerns? |journal=J. Nutr. |volume=136 |issue=6 |pages=1453–6 |year=2006 |pmid=16702302 |doi=}}</ref> | |||
* Low [[calcium]] and [[vitamin D]] intake: [[calcium]] and/or [[vitamin D deficiency]] from [[malnutrition]] | |||
* Excess [[physical activity]]: constant damage to [[bone]] and [[amenorrhea]] in females | |||
* [[Heavy metals]]: higher [[cadmium]] exposure results in [[osteomalacia]] (softening of the [[Bone-cell|bone]]).<ref name="pmid10209978">{{cite journal |vauthors=Staessen JA, Roels HA, Emelianov D, Kuznetsova T, Thijs L, Vangronsveld J, Fagard R |title=Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Public Health and Environmental Exposure to Cadmium (PheeCad) Study Group |journal=Lancet |volume=353 |issue=9159 |pages=1140–4 |year=1999 |pmid=10209978 |doi= |url=}}</ref> [[Lead]] exposure also causes [[osteoporosis]]. | |||
* Soft drinks: [[phosphoric acid]] may increase chances of [[osteoporosis]]<ref>{{cite journal |author=Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP |title=Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study |journal=Am. J. Clin. Nutr. |volume=84 |issue=4 |pages=936–42|year=2006 |pmid=17023723 |doi=}}</ref><ref>{{cite journal |author= |title=Soft drinks in schools |journal=Pediatrics |volume=113 |issue=1 Pt 1 |pages=152–4|year=2004 |pmid=14702469 |doi=}}</ref> | |||
* [[Female athlete triad|Female athlete triad syndrome]] | |||
* [[Barbiturates]]<ref>{{cite journal|author=Petty SJ, O'Brien TJ, Wark JD |title=Anti-epileptic medication and bone health |journal=Osteoporosis international |volume=18 |issue=2|pages=129–42 |year=2007 |pmid=17091219 |doi=10.1007/s00198-006-0185-z}}</ref> | |||
==Disorders, Medications, and Behaviors That May Affect Bone Mass== | |||
'''Primary Disorders''' | |||
*[[Juvenile rheumatoid arthritis]] | |||
*[[Diabetes]] | |||
*[[Osteogenesis imperfecta]] | |||
*[[Hyperthyroidism]] | |||
*[[Hyperparathyroidism]] | |||
*[[Cushing’s syndrome]] | |||
*[[Malabsorption]] syndromes | |||
*[[Anorexia nervosa]] | |||
*[[Kidney disease]] | |||
'''Medications''' | |||
*[[Anticonvulsants]] | |||
*[[Corticosteroids]] | |||
*[[Immunosuppressive agents]] | |||
'''Behaviors''' | |||
*Prolonged inactivity or [[immobility]] | |||
*Inadequate [[nutrition]] (especially lack of [[calcium]] and [[vitamin D]]) | |||
*Excessive [[exercise]] leading to [[amenorrhea]] | |||
*[[Smoking]] | |||
*[[Alcohol abuse]] | |||
== Risk factors for osteoporosis complications == | |||
=== Fracture risk factors === | |||
* Low [[Body mass index|body mass index (BMI)]] | |||
* [[Aging]] | |||
* [[Smoking]] | |||
* [[Alcoholism]] | |||
* Chronic [[corticosteroid]] use | |||
* [[Rheumatoid arthritis]] | |||
* [[Osteoporosis]] because of other diseases | |||
* [[Family history]] of [[Osteoporosis|osteoporotic]] [[fracture]] (especially [[hip]]) | |||
* [[Falling]] | |||
=== Falling risk factors<ref name="pmid25182228">{{cite journal| author=Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S et al.| title=Clinician's Guide to Prevention and Treatment of Osteoporosis. | journal=Osteoporos Int | year= 2014 | volume= 25 | issue= 10 | pages= 2359-81 | pmid=25182228 | doi=10.1007/s00198-014-2794-2 | pmc=4176573 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25182228 }}</ref><ref name="pmid20927724">{{cite journal |vauthors=Gillespie WJ, Gillespie LD, Parker MJ |title=Hip protectors for preventing hip fractures in older people |journal=Cochrane Database Syst Rev |volume= |issue=10 |pages=CD001255 |year=2010 |pmid=20927724 |doi=10.1002/14651858.CD001255.pub4 |url=}}</ref> === | |||
*'''Environmental risk factors''' | |||
**Lack of assistive devices in bathrooms | |||
**Obstacles in the walking path | |||
**Loose throw rugs | |||
**Slippery conditions | |||
**Low level lighting | |||
*'''Medical risk factors''' | |||
**[[Age]] | |||
**Medications causing [[sedation]] ([[narcotic]] [[analgesics]], [[anticonvulsants]], and psychotropics) | |||
**[[Anxiety]] and [[agitation]] | |||
**[[Orthostatic hypotension]] | |||
**[[Arrhythmias]] | |||
**Poor vision | |||
**[[Dehydration]] | |||
**Previous falls or fear of falling | |||
**[[Depression]] | |||
**Reduced problem solving or mental acuity and diminished [[cognitive]] skills | |||
**[[Vitamin D deficiency|Vitamin D insufficiency]] [serum 25-hydroxyvitamin D (25(OH)D)<30 ng/ml (75 nmol/L)] | |||
**[[Urinary incontinence|Urgent urinary incontinence]] | |||
**[[Malnutrition]] | |||
*'''Neurological and musculoskeletal risk factors''' | |||
**[[Kyphosis]] | |||
**Reduced [[proprioception]] | |||
**Poor balance | |||
**Weak muscles/[[sarcopenia]] | |||
**Impaired transfer and mobility | |||
**[[Deconditioning]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 16:41, 17 October 2017
Osteoporosis Microchapters |
Diagnosis |
---|
Treatment |
Medical Therapy |
Case Studies |
Osteoporosis risk factors On the Web |
American Roentgen Ray Society Images of Osteoporosis risk factors |
Risk calculators and risk factors for Osteoporosis risk factors |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Risk factors for osteoporosis disease are of two types, including non-modifiable and modifiable (potentially) factors. Non-modifiable risk factors include age, sex, menopause, and family history. Modifiable (potentially) risk factors include smoking, alcohol consumption, immobility, glucocorticoid abuse, and use of proton pump inhibitor (PPI).
Risk factors for osteoporosis disease
Common risk factors
- Age > 50
- Menopause (lack of estrogen)
- Family history of fracture or osteoporosis
- History of at least two fractures[1]
- Alcohol consumption
- Smoking (inhibits activity of osteoblasts)[2]
- Insufficient physical activity (lack of bone remodeling)
- Glucocorticoids (steroid-induced osteoporosis)[3]
- Proton pump inhibitors[4]
Less common risk factors
- Low body mass index (BMI): being overweight protects against osteoporosis, either by increasing load or through the leptin hormone[5]
- Low calcium and vitamin D intake: calcium and/or vitamin D deficiency from malnutrition
- Excess physical activity: constant damage to bone and amenorrhea in females
- Heavy metals: higher cadmium exposure results in osteomalacia (softening of the bone).[6] Lead exposure also causes osteoporosis.
- Soft drinks: phosphoric acid may increase chances of osteoporosis[7][8]
- Female athlete triad syndrome
- Barbiturates[9]
Disorders, Medications, and Behaviors That May Affect Bone Mass
Primary Disorders
- Juvenile rheumatoid arthritis
- Diabetes
- Osteogenesis imperfecta
- Hyperthyroidism
- Hyperparathyroidism
- Cushing’s syndrome
- Malabsorption syndromes
- Anorexia nervosa
- Kidney disease
Medications
Behaviors
- Prolonged inactivity or immobility
- Inadequate nutrition (especially lack of calcium and vitamin D)
- Excessive exercise leading to amenorrhea
- Smoking
- Alcohol abuse
Risk factors for osteoporosis complications
Fracture risk factors
- Low body mass index (BMI)
- Aging
- Smoking
- Alcoholism
- Chronic corticosteroid use
- Rheumatoid arthritis
- Osteoporosis because of other diseases
- Family history of osteoporotic fracture (especially hip)
- Falling
Falling risk factors[10][11]
- Environmental risk factors
- Lack of assistive devices in bathrooms
- Obstacles in the walking path
- Loose throw rugs
- Slippery conditions
- Low level lighting
- Medical risk factors
- Age
- Medications causing sedation (narcotic analgesics, anticonvulsants, and psychotropics)
- Anxiety and agitation
- Orthostatic hypotension
- Arrhythmias
- Poor vision
- Dehydration
- Previous falls or fear of falling
- Depression
- Reduced problem solving or mental acuity and diminished cognitive skills
- Vitamin D insufficiency [serum 25-hydroxyvitamin D (25(OH)D)<30 ng/ml (75 nmol/L)]
- Urgent urinary incontinence
- Malnutrition
- Neurological and musculoskeletal risk factors
- Kyphosis
- Reduced proprioception
- Poor balance
- Weak muscles/sarcopenia
- Impaired transfer and mobility
- Deconditioning
References
- ↑ Ojo F, Al Snih S, Ray LA, Raji MA, Markides KS (2007). "History of fractures as predictor of subsequent hip and nonhip fractures among older Mexican Americans". Journal of the National Medical Association. 99 (4): 412–8. PMID 17444431.
- ↑ Wong PK, Christie JJ, Wark JD (2007). "The effects of smoking on bone health". Clin. Sci. 113 (5): 233–41. doi:10.1042/CS20060173. PMID 17663660.
- ↑ Bone and Tooth Society of Great Britain, National Osteoporosis Society, Royal College of Physicians (2003). Glucocorticoid-induced Osteoporosis (PDF). London, UK: Royal College of Physicians of London. ISBN 1-860-16173-1.
- ↑ Yang YX, Lewis JD, Epstein S, Metz DC (2006). "Long-term proton pump inhibitor therapy and risk of hip fracture". JAMA. 296 (24): 2947–53. doi:10.1001/jama.296.24.2947. PMID 17190895.
- ↑ Shapses SA, Riedt CS (2006). "Bone, body weight, and weight reduction: what are the concerns?". J. Nutr. 136 (6): 1453–6. PMID 16702302.
- ↑ Staessen JA, Roels HA, Emelianov D, Kuznetsova T, Thijs L, Vangronsveld J, Fagard R (1999). "Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Public Health and Environmental Exposure to Cadmium (PheeCad) Study Group". Lancet. 353 (9159): 1140–4. PMID 10209978.
- ↑ Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP (2006). "Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study". Am. J. Clin. Nutr. 84 (4): 936–42. PMID 17023723.
- ↑ "Soft drinks in schools". Pediatrics. 113 (1 Pt 1): 152–4. 2004. PMID 14702469.
- ↑ Petty SJ, O'Brien TJ, Wark JD (2007). "Anti-epileptic medication and bone health". Osteoporosis international. 18 (2): 129–42. doi:10.1007/s00198-006-0185-z. PMID 17091219.
- ↑ Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S; et al. (2014). "Clinician's Guide to Prevention and Treatment of Osteoporosis". Osteoporos Int. 25 (10): 2359–81. doi:10.1007/s00198-014-2794-2. PMC 4176573. PMID 25182228.
- ↑ Gillespie WJ, Gillespie LD, Parker MJ (2010). "Hip protectors for preventing hip fractures in older people". Cochrane Database Syst Rev (10): CD001255. doi:10.1002/14651858.CD001255.pub4. PMID 20927724.