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
- 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.
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