II. Epidemiology
- Osteoporosis Prevalence in U.S.
- More than 10 Million older adults in U.S. have Osteoporosis
- wright (2014) J Bone Miner Res 29(11):2520-6 +PMID:24771492 [PubMed]
- Osteoporotic Fractures/year in U.S.: 2 to 3 Million
- Gender
- Women affected more often than men by ratio of 5:1
- Costs (hospitalizations, Nursing Home Admissions, office and ED Visits)
- Year 2002: $18 Billion/year
- Year 2026: $25 Billion/year (projected)
III. Pathophysiology
- See Bone Physiology
- Osteoporosis mechanism
- Hypogonadism (Menopause or orchiectomy)
- Osteoclastic overactivity
- Age related loss: Osteoblast Underactivity
- Trabecular Bone turnover is much more rapid
- Osteoporosis first seen in spine and Pelvis
- Trabecular Bone greater in spine and Pelvis
- Hypogonadism (Menopause or orchiectomy)
IV. Risk Factors
V. Course
- Normal bone mass
- Peak bone mass occurs at 20-35 years
- Decline in bone mass starts after age 35-50 years
- Normal bone density loss is 1% per year
-
Hypogonadism accelerates decline to 3-4% per year
- Menopause in women
- Orchiectomy in men (Prostate Cancer)
- Age 50 years
- Osteopenia in Men: 33-47%
- Osteoporosis in Men: 4-6%
- Age 65 years
- Men and women have similar rates of decline
- Age 75 years
- Dramatic increase in Incidence of Hip Fracture in men
- Age 80 years
- Women: 90% have Osteoporosis (15% Hip Fracture risk)
- Men: 50% have Osteoporosis
- Age 90 years
- Women: Hip Fracture in 33%
- Men: Hip Fracture in 17%
VI. Types
- Type 1 Osteoporosis
- Postmenopausal women
- Trabecular Bone mass decreased
- Fracture sites
- Vertebral body (T7-T9)
- Distal Forearm (Colles Fracture)
- Type 2 Osteoporosis
- Both sexes, Age over 60 years
- Both cortical and Trabecular Bone mass decreased
- Fracture sites
VII. Complications: Fractures
- Total Fracture Incidence: 1.3 Million per year
-
Hip Fracture
Incidence: 250,000 per year
- See Hip Fracture for morbidity and mortality
-
Vertebral Compression Fracture
- Occurs in 33% of women over age 50 years
VIII. Evaluation
IX. Management
X. Resources
- National Osteoporosis Foundation
- http://www.nof.org
- Phone: (800) 223-9994
- Physicians Guide to Prevention and Treatment of Osteoporosis
XI. References
- Bilezikian (1999) J Clin Endocrinol Metab 84:3431-4 [PubMed]
- Goddard (1998) Postgrad Med 104(4):54-72 [PubMed]
- Harris (2023) Am Fam Physician 107(3): 238-46 [PubMed]
- Heaney (1998) Endocrinol Metab Clin North Am 27:255-65 [PubMed]
- Jeremiah (2015) Am Fam Physician 92(4): 261-8 [PubMed]
- Orwoll (1998) Endocrinol Metab Clin North Am 27:349-67 [PubMed]
- South-Paul (2001) Am Fam Physician 63(5):897-904 [PubMed]
- Taxel (1998) Geriatrics 53(8): 22-3 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI_NCI-GLOSS) | A condition in which there is a lower-than-normal bone mass or bone mineral density (the amount of bone mineral contained in a certain amount of bone). Osteopenia is a less severe form of bone loss than osteoporosis. |
| Definition (NCI) | Decreased calcification or density of bone tissue. |
| Definition (CSP) | decreased calcification, bone density, or bone mass due to inadequate osteoid synthesis. |
| Concepts | Pathologic Function (T046) |
| MSH | D001851 |
| SnomedCT | 203889002, 156879002, 312894000, 78441005 |
| English | Osteopenias, Bone Loss, osteopenia (diagnosis), osteopenia, Osteopaenia, bone loss, Bone loss, Bone demineralized, OSTEOPENIA, BONE LOSS, Osteopenia (disorder), Osteopenia (morphologic abnormality), bone; loss, loss; bone, Osteopenia |
| Japanese | 骨減少症, ｺﾂｹﾞﾝｼｮｳｼｮｳ, ﾎﾈｿｳｼﾂ, 骨喪失, ｺﾂｿｳｼﾂ |
| Czech | osteopenie, Osteopenie, Kostní ztráta |
| Portuguese | Osteopenia, Perda óssea |
| Spanish | Osteopenia, Pérdida de hueso, osteopenia (anomalía morfológica), osteopenia (trastorno), osteopenia |
| French | Ostéopénie, Perte osseuse |
| German | Osteopenie, Knochenverlust |
| Italian | Perdita ossea, Osteopenia |
| Dutch | botverlies, bot; verlies, verlies; bot, osteopenie, Osteopenie |
| Hungarian | Osteopenia, Csontvesztés |
| Norwegian | Osteopeni |
Ontology: Osteoporosis (C0029456)
| Definition (MEDLINEPLUS) |
Osteoporosis makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women. As many as half of all women and a quarter of men older than 50 will break a bone due to osteoporosis. Risk factors include
Osteoporosis is a silent disease. You might not know you have it until you break a bone. A bone mineral density test is the best way to check your bone health. To keep bones strong, eat a diet rich in calcium and vitamin D, exercise and do not smoke. If needed, medicines can also help. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases |
| Definition (MSHCZE) | Časté onemocnění charakterizované úbytkem kostní hmoty, „řídnutí kostí“. Typ I je tzv. o. postmenopauzální (výrazně častější u žen, časté jsou fraktury obratlů a distálního předloktí, postižena je zejm. trabekulární kost), typ II je o. senilní (poměr žen k mužům je asi 2:1, frakturami je postižen skelet axiální i apendikulární, bývají zlomeniny krčku stehenní kosti, postižena je kost trabekulární i kortikální). Příčina není zcela jasná, vyskytuje se ve vyšším věku častěji u žen po přechodu nebo po odstranění vaječníků ještě v plodném období, bývá následkem dlouhodobé nehybnosti, delší léčby kortikoidy nebo důsledkem některých vzácnějších chorob. Vliv má kouření, nadměrná konzumace kávy aj. Projevuje se bolestmi (např. zad) a představuje vyšší riziko zlomeniny (krček stehenní kosti, kompresivní fraktura obratle). K diagnostice lze využít rentgenové vyšetření, osteodenzitometrii, biochemická vyšetření sledující kostní metabolismus. Léčba je dlouhodobá a může spíše jen zastavit další vývoj onemocnění. Uplatňují se kalcium, vitamin D, fluoridy, bisfosfonáty zejm. alendronát, kalcitonin, HRT, SERM, anabolika, symptomatická a fyzikální terapie; velký význam má rehabilitace (a přiměřené zatěžování kostí). Důležitá je prevence (dostatek vápníku, pohyb, u žen podávání pohlavních hormonů po – zejm. předčasném – přechodu, srov. HRT). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (NCI) | A condition of reduced bone mass, with decreased cortical thickness and a decrease in the number and size of the trabeculae of cancellous bone (but normal chemical composition), resulting in increased fracture incidence. Osteoporosis is classified as primary (Type 1, postmenopausal osteoporosis; Type 2, age-associated osteoporosis; and idiopathic, which can affect juveniles, premenopausal women, and middle-aged men) and secondary osteoporosis (which results from an identifiable cause of bone mass loss). |
| Definition (NCI_NCI-GLOSS) | A condition that is marked by a decrease in bone mass and density, causing bones to become fragile. |
| Definition (NCI_CTCAE) | A disorder characterized by reduced bone mass, with a decrease in cortical thickness and in the number and size of the trabeculae of cancellous bone (but normal chemical composition), resulting in increased fracture incidence. |
| Definition (MSH) | Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (OSTEOPOROSIS, POSTMENOPAUSAL) and age-related or senile osteoporosis. |
| Definition (CSP) | loss of bone mass and strength due to nutritional, metabolic, or other factors, usually resulting in deformity or fracture; a major public health problem of the elderly, especially women. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D010024 |
| ICD9 | 733.00, 733.0 |
| ICD10 | M81.9 , M81.0, M81.99 |
| SnomedCT | 203428004, 156825006, 203440004, 64859006 |
| LNC | MTHU020796, LA10527-2 |
| English | Osteoporoses, Osteoporosis NOS, Osteoporosis, unspecified, osteoporosis, osteoporosis (diagnosis), OSTEOPOROSIS, Osteoporosis [Disease/Finding], Unspecified osteoporosis, site unspecified, Unspecified osteoporosis, Osteoporosis, unspecified (disorder), Osteoporosis NOS (disorder), Bone rarefaction, OP - Osteoporosis, Osteoporosis (disorder), rarefaction; bone, Osteoporosis, NOS, Osteoporosis |
| French | OSTEOPOROSE, Ostéoporose, non précisée, Ostéoporose SAI, Ostéoporose |
| Portuguese | OSTEOPOROSE, Osteoporose NE, Osteoporose |
| Spanish | OSTEOPOROSIS, Osteoporosis NEOM, Osteoporosis no especificada, osteoporosis, no especificada, osteoporosis, SAI (trastorno), osteoporosis, SAI, osteoporosis, no especificada (trastorno), osteoporosis (trastorno), osteoporosis, Osteoporosis |
| German | OSTEOPOROSE, Osteoporose, unspezifisch, Osteoporose NNB, Osteoporose, nicht naeher bezeichnet, Osteoporose |
| Dutch | osteoporose NAO, niet-gespecificeerde osteoporose, rarefactio; bot, Osteoporose, niet gespecificeerd, osteoporose, Osteoporose, Porose, osteo- |
| Italian | Osteoporosi non specificata, Osteoporosi NAS, Osteoporosi |
| Japanese | 骨粗鬆症ＮＯＳ, 骨粗鬆症、詳細不明, ｺﾂｿｼｮｳｼｮｳNOS, ｺﾂｿｼｮｳｼｮｳ, ｺﾂｿｼｮｳｼｮｳｼｮｳｻｲﾌﾒｲ, 骨多孔症-老人性, 年齢関連骨消失, 年令関連骨消失, 老人性骨粗鬆症, 老年性骨粗鬆症, 外傷後骨粗鬆症, 骨消失-年齢関連, 骨多孔症-年齢関連, 骨多孔症, オステオポロシス, 骨粗しょう症, 年齢関連骨減少, 年齢関連骨多孔症, 老年性骨多孔症, 骨粗鬆症-外傷後, 年齢関連骨粗鬆症, 年令関連骨多孔症, 老人性骨粗しょう症, 年令関連骨粗しょう症, 骨減少-年齢関連, 老人性骨多孔症, 老年性骨粗しょう症, 骨粗鬆症, オステオポローシス |
| Swedish | Benskörhet |
| Czech | osteoporóza, Osteoporóza NOS, Osteoporóza, Osteoporóza, blíže neurčená, řídnutí kostí |
| Finnish | Osteoporoosi |
| Russian | OSTEOPOROZ, KLIMAKTERICHESKII OSTEOPOROZ, RAREFIKATSIIA KOSTI, OSTEOPOROZ KLIMAKTERICHESKII, OSTEOPOROZ STARCHESKII, КЛИМАКТЕРИЧЕСКИЙ ОСТЕОПОРОЗ, ОСТЕОПОРОЗ, ОСТЕОПОРОЗ КЛИМАКТЕРИЧЕСКИЙ, ОСТЕОПОРОЗ СТАРЧЕСКИЙ, РАРЕФИКАЦИЯ КОСТИ |
| Korean | 상세불명의 골다공증 |
| Croatian | OSTEOPOROZA |
| Polish | Osteoporoza pourazowa, Osteoporoza starcza, Osteoporoza, Osteoporoza związana z wiekiem, Zrzeszotnienie kości |
| Hungarian | Osteoporosis k.m.n., Osteoporosis, nem meghatározott, Osteoporosis |
| Norwegian | Osteoporose, Benskjørhet, Beinskjørhet |
