Ethnicity and Family History as Causes of Osteoporosis
Caucasian and Asian women are at highest risk of developing
osteoporosis. African American and Hispanic women have a lower, but still significant, risk. Osteoporosis and risk for fractures may be due, in part, to heredity. People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.
Secondary Causes of Osteoporosis
The loss of bone mass can also be caused by certain lifestyle factors, diseases, or medications. The majority of people with osteoporosis have at least one secondary cause.
These additional causes of secondary osteoporosis include:
Glucocorticoid Medications
Glucocorticoids are steroid medications used to treat diseases such as asthma and rheumatoid
arthritis.
Bone loss is a common side effect of these medications. The bone loss caused by these medications may be due to their direct effect on bone, muscle weakness or immobility, reduced intestinal absorption of calcium, a decrease in testosterone levels, or, most likely, a combination of these factors.
When glucocorticoid medications are used on an ongoing basis, bone mass often decreases quickly and continuously, with most of the bone loss occurring in the ribs and vertebrae. Therefore, people taking these medications should talk to their doctor about having a bone mineral density (BMD) test. Men should also be tested to monitor testosterone levels, as glucocorticoids often reduce testosterone in the blood.
A treatment plan to minimize bone loss during long-term glucocorticoid therapy may include using the minimal effective dose, discontinuing the drug, or administering it through the skin, if possible. Adequate calcium and vitamin D intake is important, as these nutrients help reduce the impact of glucocorticoids on the bones. Other possible treatments include testosterone replacement therapy and osteoporosis medication.
Alendronate and
risedronate are two bisphosphonate medications approved by the U.S. Food and Drug Administration (FDA) for use by men and women with glucocorticoid-induced osteoporosis.
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