Risk Factors for Osteoporosis
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A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop osteoporosis with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing osteoporosis. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
Risk Factors for Women
Women are at greater risk of developing osteoporosis than men. This is because they have less bone tissue than men and have a sudden drop in hormones—especially estrogen—at menopause.
Estrogen deficiencies occur as a result of:
- ]]>Menopause]]>: Natural or surgical menopause increases your risk of osteoporosis. The risk of fracture increases significantly five years after menopause. Though initial fractures may be in the wrist or spine, these strongly predict the later development of severe osteoporosis and hip fracture.
- ]]>Amenorrhea]]> (cessation of menstruation before menopause): Your risk of osteoporosis increases if you miss menstrual periods for three months or longer. Amenorrhea may occur with eating disorders, such as ]]>anorexia nervosa]]> and ]]>bulimia]]> , or with excessive or intensive exercise, such as long distance running.
Risk Factors for Men
Men have a higher bone density and lose calcium at a slower rate than women. However, after age 50, bone loss gradually increases. Risk factors for bone loss in men include:
In men, deficiencies of testosterone and to a much minor extent, estrogen, play a role in the development of osteoporosis. This may be related to:
Risk Factors in Both Sexes
Your risk of developing osteoporosis increases if you do not get enough calcium or vitamin D in your diet. An excess of phosphorous in your diet may increase your risk if your calcium and/or vitamin D intakes are low. Excessive use of alcohol, coffee, or tea may also increase your risk of osteoporosis.
Lack of Exercise
Regular exercise, especially weight-bearing and resistance exercise, helps strengthen bones. Therefore, if you don’t exercise on a regular basis, you may increase your risk of developing osteoporosis. Individuals who don’t exercise regularly also tend to have weaker muscles and poorer balance, which can lead to falls and fractures.
Smoking impairs bone, muscle, and joint health. If you smoke, you have a higher risk of developing osteoporosis.
Bone Structure and Body Weight
Small-boned women and underweight individuals of both sexes have an increased risk of osteoporosis. Individuals who are short, thin, and have narrow hips are at increased risk of low bone density and fracture.
Lack of Sunlight
The effect of sun on the skin is a primary source of vitamin D, which aids bone formation. If you get very little sun exposure and have a low dietary intake of vitamin D, you may be at increased risk of osteoporosis.
Asian and Caucasian women are more likely to develop osteoporosis than those of other ethnic groups. Though most ethnic studies have focused on women, it is believed that men in these ethnic groups carry a parallel but lower risk.
The long-term use of certain medications increases your risk of osteoporosis. Medications that increase bone loss include:
- Glucocorticoids, such as prednisone
- Immunosuppressants, such as methotrexate and cyclosporine
- Excess thyroid replacement hormone
- Anticonvulsants, such as phenytoin
- Loop diuretics— A new study has shown that these might not be associated with bone loss. ]]>*²]]>
- Medications containing aluminum, such as some antacids
- Long-term heparin therapy
- Glitazones ]]>*¹]]>
These drugs are extremely important for treating serious and chronic conditions. Do not cut back or stop your medication on your own. Discuss your concerns with your doctor.
Certain chronic diseases increase your risk for developing osteoporosis. They include:
- Liver disease, including ]]>cirrhosis]]>
- Kidney disease
- ]]>Diabetes mellitus]]>
- Scurvy (vitamin C deficiency)
Inherited disorders, including:
- ]]>Marfan]]> and Ehler-Danlos syndromes
- ]]>Cushing’s syndrome]]>
- Cancer, including lymphoma, leukemia, myeloma, and others
- Treatment for cancer, such as ]]>chemotherapy]]> or ]]>radiation]]> therapy
- Organ transplantation
- Gastrointestinal disorders, especially those causing malabsorption
Diseases in Children
Children having certain diseases are at risk for low peak bone mass and, therefore, are at increased risk of developing osteoporosis later in life. Diseases and conditions that put children include:
- Premature birth
- ]]>Anorexia nervosa]]>
- ]]>Asthma]]> or other diseases that are treated with corticosteroid drugs
- Disorders that cause malabsorption such as:
Hypogonadal (low hormone) states such as:
- Delayed puberty
- Delayed onset of periods in girls
- Infrequent or no periods in girls
Major ]]>depression]]> is associated with increased risk of osteoporosis. This could possibly be due to higher levels of the stress hormone cortisol, which may contribute to loss of bone density.
National Osteoporosis Foundation website. Available at: http://www.nof.org/ .
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ .
*¹1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-39. Epub 2008 Dec 10.
*²1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Carbone LD, Johnson KC, Bush AJ, et al. Loop diuretic use and fracture in postmenopausal women: findings from the Women's Health Initiative. Arch Intern Med. 2009;169:132-140.
Last reviewed February 2009 by ]]>Jill D. Landis, MD ]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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