Secondary Osteoporosis
Authors:
Horák Pavel
Authors‘ workplace:
III. interní klinika nefrologická, revmatologická a endokrinologická, FN Olomouc a LF Uni-verzity Palackého v Olomouci
Published in:
Clinical Osteology 2025; 30(1): 54-60
Category:
Overview
Osteoporosis is a major public health problem. Although postmenopausal and involutional osteoporosis are the most common forms, secondary causes account for up to 30 % of osteoporosis in postmenopausal women, 50 % of premenopausal osteoporosis, and 80 % of osteoporosis in men. Causes of secondary osteoporosis include lifestyle and nutritional factors, diseases that contribute to the development of bone metabolic disorders, and iatrogenic causes related to pharmacological or nonpharmacological interventions for various conditions. The need for screening for secondary causes of osteoporosis depends on the severity of osteoporosis, the absence of obvious clinical risk factors, and the patient’s age <50 years. Diagnosis of the etiology of osteoporosis may require extensive laboratory or advanced imaging studies. In individuals older than 40 years, the FRAX index can be used to assess fracture risk. Bone mineral density measurement is a valuable diagnostic method, given its interpretative limitations in some situations, for example, glucocorticoid-induced bone loss, obesity or type II diabetes mellitus. The clinical diagnosis of osteoporosis can only be established based on a differential diagnostic examination and after excluding other metabolic or tumour osteopathies. Effective treatment of the primary disease contributes significantly to the treatment of secondary osteoporosis. The basis of non-pharmacological treatment are general measures including lifestyle modification, nutrition and physical activity, correction of vitamin D deficiency and calcium intake. Antiresorptive or osteoanabolic pharmacotherapy should be individualised according to age, gender, fracture risk, comorbidities and available evidence for the specific form of secondary osteoporosis.
Keywords:
osteoporosis, secondary causes, fracture, diagnosis, therapy
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Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology OsteologyArticle was published in
Clinical Osteology
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