Osteoporosis is a disease of bone and it can lead to an increased risk of fracture. When bone mineral density or BMD reduces it is a sign of osteoporosis, bone micro architecture is disturbed, and the amount of non-collagenous proteins in bone is altered. Osteoporosis as defined by the World Health Organization in women is bone mineral density 2.5 standard deviations below peak bone mass measured at the age of 20 years.

 

It is measured by DEXA scan which means dual energy X ray absorptiometry. Established osteoporosis is used if there is presence of a fragility fracture as per WHO guidelines. Osteoporosis generally sets in women after menopause, when it is called postmenopausal osteoporosis but may men can also get affected. Osteoporosis can be prevented with lifestyle changes and few medications. Lifestyle change includes preventing falls and exercise while medication includes calcium, vitamin D, bisphosphonates and others. Various causes of Osteoporosis include -

 

• Chronic alcoholism can lead to osteoporosis
• Vitamin D deficiency and Parathormone deficiency can also lead to osteoporosis
• Smoking by various mechanisms can be a factor in causing osteoporosis
• Low body mass index is a risk factor for getting the osteoporosis
• Malnutrition and physical inactivity can be the other risk factors; Physical inactivity can also lead to osteoporosis
• Exposure to heavy metals like cadmium can lead to osteoporosis
• Osteoporosis is associated with many diseases and conditions like Turner syndrome, Klinefelter syndrome, Kallmann syndrome, anorexia nervosa, andropause, hypothalamic amenorrhea or hyperprolactinemia, bilateral oophorectomy, premature ovarian failure, testosterone deficiency
• In some endocrine disorders like Cushing's syndrome, hyperparathyroidism, thyrotoxicosis, hypothyroidism, diabetes mellitus type 1 and 2, acromegaly and adrenal insufficiency osteoporosis can be a symptom.
• Patients with rheumatologic disorders like rheumatoid arthritis, Ankylosing Spondylitis, systemic lupus erythematosus, polyarticular juvenile idiopathic arthritis, amyloidosis and Sarcoidosis are at increased risk of osteoporosis
• Renal insufficiency can lead to osteoporosis
• Patients with hematologic disorders like multiple myeloma, monoclonal gammopathies, lymphoma, leukemia, mastocytosis, hemophilia, sickle-cell disease and thalassemia are at increased risk of osteoporosis
• Several inherited disorders like Osteogenesis Imperfecta, Marfan syndrome, hemochromatosis, Hypophosphatasia, glycogen storage diseases, homocystinuria, Ehlers-Danlos syndrome, porphyria, Menkes' syndrome, epidermolysis bullosa and Gaucher's disease can lead to osteoporosis
• Several medications like steroids, Barbiturates, phenytoin, L-Thyroxine, aromatase inhibitors, warfarin, Anticoagulants, Proton pump inhibitors, aluminium-containing antacids; Thiazolidinediones and Chronic lithium therapy can lead to or can be a risk factor to osteoporosis.