Osteoporosis classification
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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
Osteoporosis may be classified into several subtypes based on disease origin, and disease severity. Osteoporosis divided to primary and secondary diseases, upon classification based on disease origin. While, it becomes divided to osteopenia, osteoporosis, and severe osteoporosis, upon classification based on disease severity.
Classification
Osteoporosis may be classified into several subtypes based on disease origin, and disease severity.
| Osteoporosis classifications | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Based on disease severity | based on disease origin | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| T-score measurement | Bone loss due to other diseases? | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| -1>T-score>-2.5 | T-score≤-2.5 | T-score≤-2.5 plus history of fracture | No | Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Osteopenia | Osteoporosis | Severe osteoporosis | Primary osteoporosis | Secondary osteoporosis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Osteoporosis classification based on disease origin
One of the major classification systems for osteoporosis is based on the origin disease come from; including:
- Primary osteoporosis: Normal process of life, through which the bone density would became low, such as aging or post-menopausal osteoporosis.
- Secondary osteoporosis: Earlier, more severe form of bone mass loss due to some kinds of pathology, such as immobilization, medication-induced (i.e., iatrogenic), endocrine dysfunction, cancer-related, and chronic kidney disease related osteoporosis.[1]
Osteoporosis classification based on disease severity
The main established classification system for osteoporosis is based on bone marrow density (BMD) in patients. The patients would be classified upon the site and method of measurements; also the used equipment and reference group of people may play roles. Finally, the major value using for classification of osteoporosis is T-score. T-score would be defined as "patient measured BMD value minus the reference BMD value (sex-matched and preferably for youth) divided the reference standard deviation (SD) (sex-matched and preferably for youth)".[2] The common classification of osteoporosis upon BMD measured T-score is as following:
- T-score less than -1 and more than -2.5 assumes as osteopenia
- T-score equal to or less than -2.5 assumes as osteoporosis
- T-score equal to or less than -2.5 with history of fracture assumes as severe osteoporosis
Lu and colleagues have found that pure using of T-score and comparing to reference normative data aged 20-29 years, as world health organization (WHO) criteria, is very inconsistent. Compared to other classification systems, it is better to standardize the normative data, maybe referring to older people; and also complex the findings of multiple sites BMD measures, in order to obtain a better classification system.[2]
References
- ↑ Marcus, Robert (2013). Osteoporosis. Amsterdam: Elsevier/Academic Press. ISBN 9780124158535.
- ↑ 2.0 2.1 Lu Y, Genant HK, Shepherd J, Zhao S, Mathur A, Fuerst TP, Cummings SR (2001). "Classification of osteoporosis based on bone mineral densities". J. Bone Miner. Res. 16 (5): 901–10. doi:10.1359/jbmr.2001.16.5.901. PMID 11341335.