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{{Osteoporosis}}
{{Osteoporosis}}
{{CMG}}; {{AE}} {{CZ}}, [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]][mailto:ravitheja.g@gmail.com]
{{CMG}}; {{AE}}{{EG}}  


==Overview==
==Overview==
Risk factors for [[osteoporosis]] [[disease]] are o two types, include:
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)]].
# Non-modifiable: age, sex, [[menopause]], and [[family history]]
# Modifiable (potentially): [[smoking]], [[alcohol]], [[immobility]], [[glucocorticoid]] abuse, and [[Proton pump inhibitor|proton pump inhibitor (PPI)]]


==Risk Factors==
==Risk factors for osteoporosis disease==


===More common===
===Common risk factors===
* Age > 50  
* Age > 50  
* [[Menopause]] (lack of [[estrogen]])
* [[Menopause]] (lack of [[estrogen]])
Line 17: Line 15:
* [[Alcohol]] consumption
* [[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>
* [[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)
* 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>  
* [[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>{{cite journal | author = {{subst:CURRENTMONTHNAME}} {{subst:CURRENTYEAR}}ang YX, Lewis JD, Epstein S, Metz DC |title=Long-term proton pump inhibitor therapy and risk of hip fracture | journal=JAMA | year=2006 | volume=296 | pages=2947-53 | id=PMID 17190895 }}</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===
===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 [[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]]
* 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
* 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]].
* [[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>
*  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]]
* [[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>
* [[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}}
{{WS}}
{{WH}}
[[Category:Endocrinology]]
[[Category:Radiology]]
[[Category:Orthopedics]]
[[Category:Primary care]]

Latest revision as of 16:41, 17 October 2017

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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

Less common risk factors

Disorders, Medications, and Behaviors That May Affect Bone Mass

Primary Disorders

Medications

Behaviors

Risk factors for osteoporosis complications

Fracture risk factors

Falling risk factors[10][11]

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ Shapses SA, Riedt CS (2006). "Bone, body weight, and weight reduction: what are the concerns?". J. Nutr. 136 (6): 1453–6. PMID 16702302.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ "Soft drinks in schools". Pediatrics. 113 (1 Pt 1): 152–4. 2004. PMID 14702469.
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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.
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