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PubMedDate not supplied

Pregnancy associated osteoporosis: the familial effect.

OBJECTIVE: The etiology and pathogenesis of pregnancy associated osteoporosis is unclear. Whether pregnancy has simply been an aggravating factor or is a direct etiologic cause responsible for severe bone loss needs to be elucidated. METHODS: In order to evaluate the contribution of familial factors to pregnancy osteoporosis, we analyzed the bone mass of 15 relatives of 5 women with pregnancy osteoporosis. Most of the patients suffered from severe back pain associated with vertebral fractures in their first pregnancy. Extensive clinical, laboratory and radiological investigations were performed to exclude secondary causes of osteoporosis. Bone mineral density measurements were performed on 15 first order family members and the results were compared with those of a control group of 20 healthy members of 5 families. RESULTS: Osteoporosis was present in 53% of the relatives of patients with pregnancy osteoporosis and in 15% of the controls (P < 0.05). CONCLUSION: These results highly suggest that some patients with pregnancy associated osteoporosis have a genetic determination of low peak bone mass, and gestation, due to its association with physiological metabolic disturbances, constitutes a risk factor for the development of skeletal fractures in these patients.

Absorptiometry, Photon↗

PubMed2002

Osteoporosis in primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) is an autoimmune liver disease that is typically progressive, with a significant proportion of patients going on to develop cirrhosis. It predominately affects women and typically develops in the middle years of life. In most centres the median age for presentation is in the range 55 to 60 years, with a significant proportion of patients first presenting over the age of 65. Due to earlier diagnosis, PBC has gone from being a rare disease, characterised by the complications of end-stage liver disease, to a significantly commoner disease (affecting up to 1 in 700 women over the age of 40) diagnosed often in an asymptomatic stage. Osteoporosis increases with advancing age and hence there is an increased prevalence of osteoporosis in older people. The question of whether osteoporosis occurs as a specific complication of PBC has latterly proved to be controversial. This article reviews the current literature and examines why differences occur in osteoporosis prevalence in the available studies. It becomes clear that when determining the true extent of the association between osteoporosis and PBC, conclusions must be drawn from large populations, and that when considering a disease such as osteoporosis that is common in older people, age matched values be used in order to draw these conclusions. As PBC is a disease that often presents for the first time over the age of 65, it is not surprising that osteoporosis is a common problem in a disease predominately affecting peri- or postmenopausal women.

Bone Diseases↗

PubMed2003

[Prevalence of osteopenia and osteoporosis assessed by densitometry in postmenopausal women].

OBJECTIVE: Our goal was to know the osteopenia and osteoporosis prevalence, determined by densitometry using dual energy X-ray absorptiometry (DXA) to measure the bone mineral density (BMD) in postmenopausal women. SUBJECTS AND METHODS: A total the 202 postmenopausal women aged 37 at 74 years old was studied, at the Gynecologist and Obstetrics Hospital No. 3 Medical Center "La Raza" from the IMSS, initiated in December 2001 to June 2002. The measurement BMD using DXA with a LUNAR device and according the WHO criteria, we have calculated the prevalence of osteopenia and osteoporosis in normal postmenopausal women at the lumbar spine (LS) and/or femoral neck (FN). RESULTS: The osteopenia prevalence in LS was: 18.2% in the group aged 45-49 years old, 47.1% in the group aged 50-54, 43.7% in the group aged 55-59, 63.6 in the group aged 60-64, 53% in the group aged 65-69, and 30% in the group aged 70-74. The overall osteopenia prevalence in LS was 43.5%, confidence interval (CI) 95% from 43.08 to 44.03%. The osteoporosis of LS was 17.1% in the group aged 50-54 years old; 21.8 in the group aged 55-59; 22.7 in the group aged 60-64; 35.29% in the group aged 65-69; and 30% in the group aged 70-74. The overall osteoporosis prevalence in the LS was 19.8% (CI) 95% from 14.3 to 25.2%. The osteopenia prevalence in FN was. 19% in the group aged 45-49 years old; 40% in the group aged 50-54; 49% in the group aged 55-59; 54% in the group aged 60-64; 76% in the group aged 65-69 and 60% in the group aged 70-74. The overall osteopenia prevalence of FN was the 48% CI 95% from 40.65-54.59%. The osteoporosis prevalence in FN: 2.38% in the group aged 45-49 years old; 7.14 in the group aged 50-54; 5.45% in the group aged 55-59; 13.6% in the group aged 60-64; 5.8 in the group aged 65-69, and 20% in the group aged 70-74. The overall osteoporosis prevalence in FN was 7.4% IC 95% from 3.6-10.68%. CONCLUSIONS: The osteoporosis prevalence in this group is less than between American women (15%), and early detection is possible between women with BMD low, in the postmenopausal women with high risk factors and primary treatment need to be established and implemented.

Absorptiometry, Photon↗

PubMed2003

Osteoporosis in postmenopausal Saudi women using dual x-ray bone densitometry.

OBJECTIVE: A pilot study to estimate the prevalence of osteopenia and osteoporosis in postmenopausal Saudi women. METHODS: Lumbar spine bone density was measured in 830 postmenopausal Saudi women 50-80 years of age (average 59 years), using dual x-ray absorptiometry (DXA) at the King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between 1989 and 1999. RESULTS: The results of the bone mineral density (BMD) in gm/cm2 were compared to the peak bone density (PBD) in healthy young women (T-score). Based on the definition of World Health Organization (WHO), the T-score value was considered for analysis. Accordingly, 248 (29.9%) subjects showed normal result, mean BMD of 1.117 +/- 0.13 and T-score of -0.66 SD; while 254 (30.6%) subjects showed osteopenia, mean BMD of 0.983 +/- 0.11 and T-score of -2.4 SD and 328(39.5%) subject showed osteoporosis, mean BMD of 0.767 +/- 0.11 and T-score of -3.4 SD. When the 830 subjects were analyzed by decades, there were 42.3% normal, 33.4% osteopenia and 24.3% osteoporosis in age 50-59 years; 11% normal, 27% with osteopenia and 62% with osteoporosis in age 60-69 years while in older age 70-79 years only 4.6% had normal BMD, 21.5% had osteopenia and 73.8% had osteoporosis. CONCLUSION: Osteopenia and osteoporosis are common among postmenopausal Saudi women and should be considered as a matter of public health. Bone densitometry should be used to assess the severity of bone loss, identify those who need therapy and for follow up and early diagnosis of those with osteopenia in order to institute proper therapy and avoid future osteoporosis.

Absorptiometry, Photon↗

PubMed1992

[A study of risk factor in osteoporosis, femoral neck fracture and colles' fracture].

This work studied risk factors of osteoporosis, femoral neck fracture and Colles' fracture. The results were compared with those of a healthy group. Milk intake was frequent in the healthy group, but rare in the femoral neck fracture or Colles' fracture group. Most of osteoporosis and femoral neck fracture group were bed ridden, or stayed indoors for a long time before injury. They weighed less and were thin as compared to the healthy group. Decrease of activities of daily living and less body weight were risk factors of osteoporosis and femoral neck fracture, but these risk factors were more predominant in the femoral neck fracture than osteoporosis group. In this study, 74.4% of the patients with femoral neck fracture also had osteoporosis and 33.3% with Colles' fracture had osteoporosis. Colles' fracture was related to injury force and femoral neck fracture was found to be closely related to osteoporosis.

Activities of Daily Living↗

PubMed2003

[Missed diagnosis of osteoporosis and failure to treat adults with hip fracture in Chile].

BACKGROUND: Hip fractures are the most severe complication of osteoporosis, yet patients who suffer hip fracture rarely receive adequate treatment. AIM: To assess diagnosis and treatment of osteoporosis in patients with hip fracture. PATIENTS AND METHODS: A retrospective study in 203 patients admitted for hip fracture surgery at two medical institutions in Santiago, Chile. Clinical data from 101 patients from the Hospital Clínico Pontificia Universidad Católica de Chile (a university tertiary care hospital, HCPUC) and 102 patients from Hospital de Urgencia de la Asistencia Pública (a public emergency hospital, HUAP) were reviewed. We also evaluated incidence of new fractures, further treatment of osteoporosis and functionality, by means of a telephonic survey of 48% of patients (n = 99) 12.3 +/- 5.3 months after hip fracture in HCPUC and 16.5 +/- 3.0 months for HUAP. RESULTS: A previous diagnosis of osteoporosis was present in 2.9% and 1% of cases, and treatment prior to fracture in 3.9% and 0% of cases from HCPUC and HUAP, respectively. None of the patients in HUAP were diagnosed with osteoporosis during hospital stay or given treatment for this condition at discharge, in comparison to 0.9% (n = 1) and 2% (n = 2), respectively, in HCPUC. Seven and six percent of cases presented prior hip fractures. Telephonic follow up of patients revealed that 75.6% persisted without treatment for osteoporosis. At follow up, 2.9% and 3% of patients in HCPUC and HUAP had presented new hip fractures. At the time of survey 30.9% and 34% of patients, respectively, were considered invalid. CONCLUSIONS: Missed diagnosis and failure to treat osteoporosis occurred in over 90% of patients admitted for hip fracture, regardless of the different complexities in the hospitals of admission. The data suggest that lack of medical action on these issues may play a role in failure to prevent new hip fractures.

Aged↗

PubMed2003

Teriparatide (rhPTH 1-34) for the treatment of osteoporosis.

Osteoporosis is a skeletal disorder characterised by compromised bone strength predisposing a person to an increased risk of fracture. Osteoporosis develops through an imbalance between bone resorption by osteoclasts and bone formation by osteoblasts resulting in increased bone loss. Numerous agents used for the prevention and treatment of osteoporosis slow bone loss by decreasing both bone resorption and formation. These include bisphosphonates, hormone replacement therapy, selective oestrogen receptor modulators and calcitonins. All reduce vertebral fracture risk and some reduce non-vertebral fracture risk, but none routinely increases bone mass and strength or restores lost bone architecture. In many respects, antiresorptive therapies halt the progression of osteoporosis. However, for patients who have osteoporosis, particularly those who have sustained their first fracture and are at high risk for subsequent fractures, there is a need to develop agents that stimulate bone formation and, thus, reverse osteoporosis. Teriparatide is the recombinant human 1-34 amino acid sequence of parathyroid hormone recently approved in the US for the treatment of men and postmenopausal women at high risk for osteoporotic fracture and in Europe for the treatment of postmenopausal women with osteoporosis. When given by once-daily injection, teriparatide increases bone mass by stimulating formation of new bone, resulting in the restoration of bone architecture.

Bone Density↗

PubMed2003

Prevention and management of osteoporosis.

Bone is hard tissue that is in a constant state of flux, being built up by bone-forming cells called osteoblasts while also being broken down or resorbed by cells known as osteoclasts. During childhood and adolescence, bone formation is dominant; bone length and girth increase with age, ending at early adulthood when peak bone mass is attained. Males generally exhibit a longer growth period, resulting in bones of greater size and overall strength. In males after the age of 20, bone resorbtion becomes predominant, and bone mineral content declines about 4% per decade. Females tend to maintain peak mineral content until menopause, after which time it declines about 15% per decade. Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine, and wrist. Osteoporosis occurs primarily as a result of normal ageing, but can arise as a result of impaired development of peak bone mass (e.g. due to delayed puberty or undernutrition) or excessive bone loss during adulthood (e.g. due to estrogen deficiency in women, undernutrition, or corticosteroid use). Osteoporosis-induced fractures cause a great burden to society. Hip fractures are the most serious, as they nearly always result in hospitalization, are fatal about 20% of the time, and produce permanent disability about half the time. Fracture rates increase rapidly with age and the lifetime risk of fracture in 50 year-old women is about 40%, similar to that for coronary heart disease. In 1990, there were 1.7 million hip fractures alone worldwide; with changes in population demographics, this figure is expected to rise to 6 million by 2050. To help describe the nature and consequences of osteoporosis, as well as strategies for its prevention and management, a WHO Scientific Group meeting of international experts was held in Geneva, which resulted in this technical report. This monograph describes in detail normal bone development and the causes and risk factors for developing osteoporosis. The burden of osteoporosis is characterized in terms of mortality, morbidity, and economic costs. Methods for its prevention and treatment are discussed in detail for both pharmacological and non-pharmacological approaches. For each approach, the strength of the scientific evidence is presented. The report also provides cost-analysis information for potential interventions, and discusses important aspects of developing national policies to deal with osteoporosis. Recommendations are made to the general population, care providers, health administrators, and researchers. Lastly, national organizations and support groups are listed by country.

Aged↗

PubMed2004

Medical management of osteoporosis.

Osteoporosis is a cause of considerable morbidity and mortality in men and women. Medical intervention can reduce the progression of osteoporosis and decrease the fracture risk associated with low bone mineral density. In this article, we review the evidence for medical therapies for osteoporosis, including estrogen, calcitonin, bisphosphonates, selective estrogen receptor modulators, and the newest approved agent, recombinant human parathyroid hormone. We also discuss several controversial areas in osteoporosis treatment, including the management of men with osteoporosis, approach to monitoring the effects of osteoporosis therapy, and need for cost-effective strategies for osteoporosis treatment.

Calcium↗

PubMed2004

[Factors of avascular necrosis of femoral head and osteoporosis in SARS patients' convalescence].

OBJECTIVE: To explore the factors affecting the pathogenesis of avascular necrosis of femoral head and osteoporosis of SARS patients during convalescent stage. METHODS: The clinical data of 40 SARS patients, 12 males and 28 females, aged 29 +/- 9, hospitalized from April to June 2003, were reviewed, targeted on the use of glucocorticoids. Three months after the discharge ELISA and indirect immunofluorescent antibody (IFA) assay were used to detect the serum IgG. Magnetic resonance imaging (MRI) was used to detect the damage of the head of femur and quantitative ultrasound (QUS) was used to detect osteoporosis at the left heel. RESULTS: The average total dosage of methylprednisolone was (4949 +/- 2959) mg, and the average course of treatment was (24 +/- 5) days (16 to 30 days). Twenty-three patients underwent ictus therapy of corticosteroids for (8 +/- 4) days. The extenuation time of corticosteroid' dosage was (33 +/- 26) mg/d. Of the 40 patients, 36 were IgG positive with an average A value of (0.91 +/- 0.24) and 4 patients were IgG negative. Twelve patients (30%) were with type I avascular necrosis of femoral head, including 3 cases with unilateral left--necrosis and 9 cases of bilateral necrosis. The other 28 patients were without necrosis. Two patients were suffering from osteoporosis and 30 patients were with bone density decrement. The average Z values of the parameter BUA and VOS were (-1.26 +/- 0. 53) and (-0.53 +/- 0.30) respectively. The corresponding T values of the parameter BUA and VOS were (-1.49 +/- 0.59) and (-0.65 +/- 0.05) respectively. The influencing factors of femoral necrosis included the degree of healing activity, the dosage summation of corticosteroids, and length of ictus therapy. The influencing factors of bone density included age, dosage summation, and length of ictus therapy. The influencing factors of the bone fabric and flexibility included the use and length of ictus therapy. Statistics showed that serum IgG was not related with avascular necrosis of femoral head and osteoporosis. CONCLUSIONS: The incidence rates of avascular necrosis of femoral head and of osteoporosis were higher in convalescent SARS patients than in general population. The influencing factors of femoral necrosis included the degree of healing activity, the dosage summation of corticosteroids, and length of ictus therapy. The influencing factors of bone density included age, dosage summation, and length of ictus therapy. The influencing factors of the bone fabric and flexibility included the use and length of ictus therapy. Statistics showed that serum IgG was not related with avascular necrosis of femoral head and osteoporosis. SARS virus may not affect the pathogenesis of avascular necrosis of femoral head and osteoporosis.

Adolescent↗

PubMed2004

[Primary osteoporosis risk factors in women from Córdoba, Argentina].

UNLABELLED: Risk factors for osteoporosis were evaluated in women from Cordoba, Argentina. Female patients that consulted about diagnosis or treatment of osteoporosis from January 2000 to June 2002 were included. Secondary osteoporosis patients were excluded. Participants were studied using standardized questionnaire, clinical examination, biochemical analysis, and dual-energy X-ray absorptiometry (DXA). According to lumbar spine DXA results and WHO criterion, we considered 2 groups: Osteoporosis (T score < -2.5 standard deviation, SD) and Control (T score > or = -2.5 SD). One hundred and fifty five women (Osteoporosis Group: 47; CONTROL GROUP: 108) were studied. In univariate analysis age, years from menopause, weight, smoking duration, estrogen replacement therapy duration, bilateral oophorectomy with hysterectomy, alkaline phosphatase levels, and Pouteau-Colles fractures were different between both groups. After multivariate analysis, including variables that were statistical different in univariate analysis, and considering osteoporosis as dependent variable, body weight (Odds Ratio, OR=0.92; CI 95% 0.87-0.98), alkaline phosphatase (OR=1.01; CI 95% 1.00-1.02), years from menopause (OR=1.12; CI 95% 1.05-1.21), and Pouteau-Colles fractures (OR=15.15; CI 95% 1.68-135.7) were independent risk factors for osteoporosis.

Adult↗

PubMed2005

[The diagnosis of osteoporosis].

The diagnosis of Osteoporosis on WHO Technical Report of Prevention and Management of Osteoporosis in 2003, in addition to present status in Japan, has been reviewed. Since Technical Report of Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis was published by WHO in 1994, the field of osteoporosis has progressed remarkably. In particular, in regard to methods of measuring bone mass or density, diagnosis, assessment of fracture risk, and assessment of osteoporosis, this Technical Report describes evidences, confirmed from current many data, and provides informations available to osteoporosis practice. This Report also shows future direction and issues of osteoporosis which should be resolved.

Bone Density↗

PubMed2005

[Self-efficacy and health behaviors associated with osteoporosis of middle-aged and elderly subjects: a community-based study].

OBJECTIVE: To understand the self-efficacy and health behaviors with respect to osteoporosis of middle-aged and elderly subjects living in the communities. METHOD: A questionnaire-based survey was conducted using the Osteoporosis Self-Efficacy Scale (designed by Horan M et al ) and osteoporosis health behaviors questionnaire designed by the authors among 290 middle-aged and elderly community dwellers. RESULTS: The mean score of the self-efficacy was 64.75+/-21.93 among the involved subjects without statistically significant difference in terms of gender and intensity of daily exercises. The score differed significantly, however, in terms of age, education background, occupation and calcium intake (P<0.01), and the older group had lower scores than the younger one. Subjects with higher education scored higher, and those with occupations of physical labor scored lower than those with intellectual work. Higher calcium intake also resulted in higher score. It was found in this survey that the preventive behaviors of osteoporosis was insufficient among the subjects, and only 36.1% of the subjects drank milk everyday with 29.2% often having bean products and 49.8% taking calcium supplements. A percentage of 58.1% of these subjects regularly took part in exercises more than 3 times a week for over 30 minutes each time, but they seldom took weight bearing exercise. CONCLUSION: Osteoporosis self-efficacy should enhanced to promote osteoporosis- preventing behaviors in osteoporosis education program for the middle-aged and elderly people in the communities.

Aged↗

PubMed2005

[Intervention in lifestyle factors for the prevention of osteoporosis and osteoporotic fractures].

According that osteoporosis is the common condition in an aging society such as in Japan, much progress has been made in understanding the treatment and prevention of osteoporosis. Among potential risk factors, exercise, smoking, and alcohol consumption have been recognised as important lifestyle factors that might influence the risk of osteoporosis and osteoporotic fractures. To assess the relationship between these lifestyle factors and the risk for low bone mass and osteoporosis-related fractures, a systematic literature search over past 13 years was conducted. Accumulating evidence indicates that exercises decrease the risk for hip fractures among middle aged and older men and women. Exercises also help to maintain muscle strength, muscle volume, balance, and joint flexibility, which might prevent falls and fall-related fractures. One randomised controlled trial indicates that high-impact and/or weight-bearing exercise might increase the bone density in the elderly and the peak bone mass among young women. The literature search also address that there is an association between cigarette smoking and the risk of osteoporosis. Smoking cessation is effective to decrease the risk for both osteoporosis and osteoporotic fractures. Future research should be required to evaluate the alcohol consumption and osteoporosis.

Adult↗

PubMed2005

[Early, noninvasive diagnostic of osteoporosis in men].

Osteoporosis is the most frequent metabolic bone disease. Until recently it was believed to mainly affect women in menopause. A review of the literature indicates that a lot of the research to date on women. The patogenesis of bone loss in men has not been explained yet. It has not been determined what is the contribution of androgens as opposed to environmental factors and stimulants. The behaviour of bone turnover markers during ageing and their role in diagnosing the risk of osteoporosis development and fractures in men are not clear. The objective of the paper was to evaluate bone metabolism markers and to determine their relevance in early diagnosis of osteoporosis in men, and to determine any possible impact of testosterone concentration on bone mass. The study covered 100 volunteers-males, aged 40-85. All were subjected to a densitometric examination, using theDEXA method, of three regions of the osseous system: lumbar spine in anterior-posterior height, proximal femur, distal radius. Based on these results, subjects were divided into three groups: without osteoporosis, with osteopenia and with osteoporosis. In all men the serum level of the following was marked: 1) 3 markers of bone formation: osteocalcin (BGP), bone alkaline phosphatase (b-ALP) and Procollagen I Aminoterminal propeptide (PINP); 2) 2 markers of bone resorption: Collagen Type I Crosslinked C-telopeptide (Ctx) and Tartarate Resistant Acid Phosphatase (TRAP); 3) testosterone. The results obtained were subjected to thorough statistical analisis. Mean concentrations of bone metabolism, testosterone and calcium consumption in the groups examined were compared by mean of ANOVA variance analysis and the smallest significant difference test. Relationship between markers of bone resorption and formation, testosterone level and bone mineral density (BMD) were shown by means of Pearson linear correlation. The relevance of markers in the diagnosing of osteoporosis in men was evaluated by means of the ROC curves. The results obtained lead to the following conclusions: Among the markers of bone turnover analysed, Collagen Typ I Crosslinked C-telopeptide (Ctx-serum) is the most useful marker in the diagnosis of osteoporosis in men, followed by Tartarate Resistant Acid Phosphatase (TRAP) and osteocalcin (BGP). There is no relationship between bone mineral density and serum testosterone level.

Absorptiometry, Photon↗

PubMed2006

Osteoporosis--diagnosis and treatment in a general practice population.

BACKGROUND: Osteoporosis may be underdiagnosed and undertreated. General practitioners are best placed to redress this. METHODS: The research group invited all GPs in Bendigo (Victoria) (60) to attend an educational evening about osteoporosis, and also to engage in subsequent research involving data extraction from their electronic medical records for 2003. Twenty-three GPs accepted the invitation to participate. The research group calculated the proportion of patients with osteoporosis recorded as a diagnosis in their medical record, and compared them with national prevalence estimates based on radiological diagnosis. RESULTS: The research group assessed 29 356 patient records of the 23 participating GPs, identifying 593 cases of osteoporosis. In patients aged over 59 years, osteoporosis was diagnosed in 12.6% of women and 3.8% of men. Of identified cases, 53.4% were prescribed antiresorptive drugs. DISCUSSION: The occurrence of a diagnosis of osteoporosis was well below radiologically estimated prevalence. Implementation of learning opportunities designed to improve GP recognition and treatment of osteoporosis could be beneficial. Electronic medical records can provide useful research data with privacy protected.

Aged↗

PubMedDate not supplied

The search for human osteoporosis genes.

Osteoporosis is the most prevalent metabolic bone disease and a major clinical and public health problem. Heredity plays an important and well-established role in determining the lifetime risk of this disease. Major efforts are currently underway to identify the specific genes and their allelic variations that contribute to the heritable component to osteoporosis. A number of laboratories are using quantitative trait locus (QTL) methods of genome scanning in families and animal models to identify candidate genomic regions and, ultimately, the genes and genetic variations that lead to osteoporosis. Several chromosomal regions of the human genome have now been linked to osteoporosis-related phenotypes. Although the specific genes contributing to the majority of these linkage signals have not been identified, two positional candidate genes have now been identified: low density lipoprotein receptor-related protein 5 (LRP5) and bone morphogenetic protein 2 (BMP2). A number of QTL has also been identified by cross-breeding strains of mice with variable bone density and several of these QTL have been fine mapped, providing a rich new base for understanding osteoporosis. Genetic association analyses have also provided evidence for a modest relationship between allelic variants in several biological candidate genes and bone mass and the risk of fracture. These ongoing animal and human studies will provide a continuing source of new insight into the genetic regulation of bone and mineral metabolism and the molecular etiology of osteoporosis. The new insight that will emerge from this ongoing research should lead to new ways of diagnosing, preventing and treating the growing clinical and public health problem of osteoporosis.

Animals↗

PubMed2006

Prednisone-induced osteoporosis: an overlooked and undertreated adverse effect.

CONTEXT: Glucocorticoids are used for a variety of medical conditions. This class of drugs is arguably the most common cause of iatrogenic osteoporosis, but studies have shown that physicians are not investigating and treating glucocorticoid-induced osteoporosis. OBJECTIVE: To determine whether primary care physicians (osteopathic and allopathic) are evaluating and treating adult patients at risk for osteoporosis secondary to long-term prednisone use. METHODS: Electronic medical records from three primary care practices (family medicine, geriatric medicine, and internal medicine) were retrospectively reviewed to identify patients who were taking at least 2.5 mg of prednisone per day for 8 weeks or longer. Records were then grouped according to whether patients had undergone bone mineral density screening and had been given therapy to prevent or treat bone loss. Whether patients had comorbid risk factors for secondary osteoporosis (according to the National Institutes of Health Consensus Development Conference Statement on Osteoporosis) was noted to determine whether treatment was given because of prednisone use or because of the comorbid risk factors. Statistical analysis was performed using a Pearson product moment correlation 2-tailed chi2 test. RESULTS: The medical records of 49 patients met inclusion criteria (19 men, 30 women; mean age, 61 years; age range, 21-89 years). A statistically significant difference was found in physician evaluation practices for patients with vs patients without comorbid risk factors (82.1% vs 38.1%; P=.002). CONCLUSION: Primary care physicians do not routinely evaluate patients for osteoporosis secondary to glucocorticoid treatment, especially when patients do not have comorbid risk factors for osteoporosis.

Adult↗