Osteoporosis: Overview and Risk Factors

Osteoporosis is a disease in which bones become thin and brittle. As a result, fractures and falls are common, and may be life–threatening. In particular, osteoporosis can lead to hip fractures. The complications of these fractures prove fatal in nearly 25 percent of cases.

While most cases of osteoporosis occur in the absence of an underlying disease, about 5 percent of cases are related to various medical disorders. These include disease of the thyroid or parathyroid glands, diabetes mellitus, chronic kidney disease, liver disease, intestinal malabsorption, pancreatic disease, cancers, and certain medications, such as corticosteroids, aluminum–containing antacids, and heparin.

Risk Factors

In general, non–Hispanic Caucasians are at greater risk than persons of Latin American or African heritage. African–Americans have greater bone densities and a lower risk of fracture, compared with white Americans.

Many risk factors are associated with osteoporosis. The following are among the most common:

• Age: In postmenopausal women, fracture risk increases with age. Both men and women aged 70 and older have an increased risk of fracture.
• Female gender: Osteoporosis is six times more common in women than in men. Also, osteoporosis begins earlier and tends to be more severe in women.
• Weight: Persons with lower body mass have lower bone mineral density. Obesity reduces the risk of developing osteoporosis.
• Sedentary lifestyle
• Genetic factors
• Previous fracture
• Smoking
• Medications and supplements: Vitamin A, heparin, aluminum–containing antacids, and medroxyprogesterone increase risk, whereas thiazide diuretics, estrogen, and androgens are protective.
• High alcohol consumption: While a moderate–to–low alcohol intake is associated with a modestly reduced risk, higher consumption increases the risk.
• Early onset of menopause
• Calcium or vitamin D deficiency
• Dietary factors (see Nutritional Considerations)