Causes Of Osteoporosis

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[edit] Causes Of Osteoporosis

There are a few risk facors worth mentioning: being elderly; females are at a higher risk than males.

At age 90 about 50% of females have osteoporosis whereas only 15% of males have it. On of the effects of smoking is to develop osteoporosis and in women this also contributes to an early menopause, which is in itself a higher risk (less estrogen exposure). High alcohol consumption such as the equivalent of more than 14 beer for women and more than 21 beer for men per week are a risk factor for osteoporosis. This may be also because of hypogonadism that is associated weith heavy drinking. For the same reason hypogonadism from starvation (anorexia nervosa) or excessive athletic exercise is also a cause of osteoporosis. There is a strong hereditary factor in about 2/3 of all cases.

Osteoporosis is usually divided into primary and secondary osteoporosis. With secondary osteoporosis there is another primary cause as shown in the table, which causes the osteoporosis. In other words, osteoporosis is only a symptom of another underlying disease, which affects bone metabolism. Primary osteoporosis means that this is the primary disease. Primary osteoporosis can be divided again into two osteoporosis types, type I and type II osteoporosis (see table below, modified from Ref. 1).

Causes of osteoporosis
Primary osteoporosis
Causes:	Comments:
Type I	postmenopausal or low testosterone level in males
Type II	senile, possible lack of vitamin D utilization
ideopathic	age less than 50, possibly genetically caused
Secondary osteoporosis
Causes:	Comments:
endocrine	hyperthyroidism, hyperparathyroidism, hypogonadism, Cushing syndrome
gastrointestinal	celiac disease, partial gastrectomy, liver disease like primary biliary cirrhosis
rheumatological	ankylosing spondylitis, rheumatoid arthritis
cancerous	multiple myeloma, bone metastases from cancer
drugs	heparin, corticosteroids, alcohol abuse

Type I osteoporosis is due to postmenopausal (or andropausal) bone changes. It occurs because of a lack of estrogen in women or testosterone in males, affects the ages of 50 to 75 and leads to fractures of the radius close to the wrists (Colles' fractures) or the tibia (ankle fractures). Type II osteoporosis is the senile type, occurs beyond age 60 and affects the femoral neck (hip fractures), upper arm and upper tibia bones, the vertebral bodies and the pelvic bone.

For more info on causes of osteoporosis and an image of osteoporotic bone click on the link.

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References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith M.D., BMJ Books, 1999.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 57.

3. B. Sears: "The age-free zone".Regan Books, Harper Collins, 2000.

4. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.

5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

6. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier