From the Guidelines
Osteoporosis is a condition characterized by decreased bone density that increases fracture risk, diagnosed by the occurrence of fragility fracture or low bone mineral density (BMD) as measured by dual-energy x-ray absorptiometry (DXA) 1.
Definition and Diagnosis
Osteoporosis can be diagnosed by the occurrence of fragility fracture, or in patients without fragility fracture, by low BMD as measured by DXA, which is the current gold standard test for diagnosing osteoporosis in people without an osteoporotic fracture 1.
- The international reference standard for the description of osteoporosis in postmenopausal women and in men aged 50 years or older is a femoral neck BMD of 2.5 SD or more below the young female adult mean 1.
- Results of DXA are scored as SDs from a young, healthy norm (usually female) and reported as T scores, with a T score of –2 indicating a BMD that is 2 SDs below the comparative norm 1.
Risk Factors
Risk factors for osteoporotic fracture include increasing age, female sex, post-menopause for women, hypogonadism or premature ovarian failure, low body weight, history of parental hip fracture, ethnic background, previous clinical or morphometric vertebral fracture, previous fracture due to minimal trauma, rheumatoid arthritis, current smoking, alcohol intake, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, falling, and immobilization 1.
- Long-term use of certain medications, such as glucocorticoids, anticoagulants, anticonvulsants, aromatase inhibitors, cancer chemotherapeutic drugs, and gonadotropin-releasing hormone agonists, is also a risk factor for osteoporotic fracture 1.
Treatment and Prevention
While the question asks for a definition, it's essential to note that treatment typically includes calcium and vitamin D supplementation, along with weight-bearing exercise, and first-line medication therapy usually involves bisphosphonates, which work by inhibiting bone resorption, allowing bone formation to outpace breakdown 1.
- For those who cannot tolerate bisphosphonates, alternatives include denosumab, which blocks bone resorption by inhibiting RANK ligand, or anabolic agents like teriparatide or abaloparatide that stimulate new bone formation 1.
Key Points
- Osteoporosis is a condition that increases fracture risk due to decreased bone density.
- DXA is the gold standard for diagnosing osteoporosis.
- Risk factors include age, sex, low body weight, and long-term use of certain medications.
- Treatment involves calcium and vitamin D supplementation, weight-bearing exercise, and medication therapy, typically with bisphosphonates.
From the Research
Definition of Osteoporosis
Osteoporosis is a systemic skeletal disorder characterized by bone loss, which leads to impaired bone strength and an increased risk of fractures 2.
Key Characteristics
- Bone loss and impaired bone strength
- Increased risk of fractures
- Affects both men and women, although postmenopausal women are at higher risk
Treatment and Prevention
- Bisphosphonates are widely used for the prevention and treatment of osteoporosis, reducing the risk of fracture by suppressing bone resorption and increasing bone strength 3, 4, 5, 6, 2
- Other treatments, such as teriparatide and romosozumab, may also be effective in preventing fractures and increasing bone mineral density 3