Osteoporosis and Osteopenia
A skeletal disease characterized by low bone mass, with disruption of bone architecture leading to compromised bone strength and risk of fracture.
- Predominant age: elderly >60 years of age
- Predominant sex: female > male (80%/20%)
- >2 million fractures annually attributed to osteoporosis in the United States.
- >9.9 million Americans have osteoporosis.
- >43.1 million Americans have osteopenia.
- Women >50 years of age: osteoporosis 15.4% and osteopenia 51.4%
- Men >50 years of age: osteoporosis 4.3% and osteopenia 35.2%
Etiology and Pathophysiology
- Imbalance between bone resorption/formation
- Familial predisposition
- More common in Caucasians and Asians than in African Americans and Hispanics (1)
Commonly Associated Conditions
- Malabsorption syndromes: gastrectomy, inflammatory bowel disease, celiac disease
- Hypoestrogenism: menopause, hypogonadism, eating disorders, etc.
- Endocrinopathies: hyperparathyroidism, hyperthyroidism, hypercortisolism, diabetes mellitus
- Hematologic disorders: sickle cell disease, multiple myeloma, thalassemia, hemochromatosis
- Other chronic diseases: multiple sclerosis, end-stage renal disease, rheumatoid arthritis, lupus, COPD, HIV/AIDS
- Medications: chemotherapy agents, antiepileptics, aromatase inhibitors (raloxifene), chronic corticosteroids (equivalent to at least 5 mg prednisone daily for at least 3 months), medroxyprogesterone acetate, heparin, SSRIs, thyroid hormone (in supraphysiologic doses), PPIs
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