Monday, 25 November 2013

Osteoporosis – The Risk factors

Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of  the loss of bone density over a long period of time.
B. Risk factors
1. Young Age at Diagnosis, Male Sex, and Decreased Lean Mass
In the study to investigate the prevalence and identify the risk factors of osteoporosis. METHODS:: Forty long-term survivors of osteosarcoma and 55 controls were enrolled. The mean age of the survivors was 21.8±5.2 years. They were diagnosed at younger than 23 years of age (mean, 14.9+5.0 y). Bone mineral densities (BMD) and body compositions were measured by dual-energy x-ray absorptiometry, showed that nineteen (47.5%) subjects had osteoporosis and 12 (30.0%) had osteopenia. The regions affected by osteoporosis were: femur neck of osteosarcoma site (47.5%), unaffected femur neck (12.5%), lumbar spine (12.5%), and total body (15.0%). Twelve subjects (30.0%) had 14 episodes of fractures. The identified risk factors of osteoporosis were young age at diagnosis, male sex, and low lean mass. Subjects diagnosed before attainment of puberty (male≤16 y, female≤14 y) were found to have a higher prevalence of osteoporosis (37.5% vs. 10.0%, P<0.01). Males had a higher prevalence of osteopenia or osteoporosis than females (86.4% vs. 66.7%, P<0.01). Total lean mass was positively correlated with unaffected femur neck BMD. Regional lean mass in affected limb was significantly reduced along with affected femur neck BMD(12).
2. Male sex, a low lean mass, and adult growth hormone replacement
There was the high prevalence of osteoporosis and osteopenia, 25.0% and 42.9%, respectively, and three additional risk factors, male sex, a low lean mass, and adult growth hormone replacement, were identified, according to the study by Seoul National University College of Medicine(13).
3. Aging
Bone loss occurs during the normal aging process. The term “primary” osteoporosis refers to osteoporosis that results from the involutional losses associated with aging and, in women, additional losses related to natural menopause, according to the study by Department of Medicine, College of Physicians and Surgeons, Columbia University(14).
4. Chlamydia pneumoniae
there is an association between the presence of Chlamydia pneumoniae DNA both in osteoporotic bone tissue and peripheral blood mononuclear cells (PBMCs) and the increase in circulating resorptive cytokines(15).
5. Race
Research on ethnically diverse populations is necessary to better understand how lactose maldigestion influences the risk for osteoporosis. Low calcium intakes, a greater than previously thought potential for low bone density and extensive lactose maldigestion among Hispanic-American and Asian-American populations may create an elevated risk for osteoporosis(16).
6. Family history
In the study to assess the relationship between the prevalence of reported physician-diagnosed osteoporosis and family history in a representative sample of U.S. women, examine whether osteoporosis risk factors account for this relationship, and evaluate the likelihood that women at high risk of osteoporosis due to family history report preventive behaviors, showed that family history is a significant, independent risk factor for osteoporosis in U.S. women aged>or=35 years. Further studies are warranted to evaluate family history as a convenient and inexpensive tool for identifying women at risk of osteoporosis and for promoting the adoption of preventive behaviors(17).
7. Skin color and body size
In the comparison of skin color, body size and bone mineral density (BMD) among three groups of postmenopausal women: 104 healthy black women, 45 healthy white women, and 52 osteoporotic white women with vertebral fractures. The osteoporotics are above the ideal body mass index recommended by the National Institutes of Health, researchers found that fair skin is not a risk factor for osteoporosis and that large body size is not protective against the development of osteoporosis, although it may have a salutary effect on BMD in both blacks and whites(18).
8.  Diet and lifestyle
In the study of total of 632 women age > or =60 years were enrolled in this study. Subjects were interviewed about their lifestyle by means of a questionnaire regarding the consumption pattern of dietary items, showed that the BMD was higher in subjects with the habits of alcohol drinking, green tea drinking, and physical activity and lower in those with the habits of smoking and cheese consumption. Multiple regression analysis showed that factors associated with BMD were smoking, alcohol consumption, green tea drinking, and physical activity after adjusting for age and body mass index (BMI)(19).
9. Heavy alcohol intake or alcoholism
Heavy alcohol intake or alcoholism, however, frequently disrupts calcium and bone homeostasis, which leads to reduce bone mineral density and increase the incidence of fragility fracture, according to the studyby Department of Endocrinology and Metabolism, Saitama Medical School(20).
10. Smoking and lower serum IGF-I levels
In the study of age, body mass index, current smoking history, and serum insulin-like growth factor-I levels associated with bone mineral density in middle-aged Korean men, suggest that higher age, a lower BMI, current smoking history, and lower serum IGF-I levels are risk factors for lower BMD in middle-aged Korean men; however, serum testosterone levels and GH secretory capacity were not found to be correlated with BMD(21).
11. Other risk factors
The frequency of decreased bone mineral density, vitamin and calcium diet content and sufficiency with vitamins evaluated by means of blood serum level determination among patients suffering from chronic diseases (of cardiovascular system, gastrointestinal tract, osteopenia and osteoporosis)(22).
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