Osteoporosis and Risk Factors

Osteoporosis literally means a condition of having porous bones. Bone is a living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs when the formation of new bone doesn’t keep up with the removal of old bone. It causes bones to become brittle and weak so that even mild stresses like bending over or coughing can cause a fracture. Fractures related to osteoporosis most commonly occur in the hip, wrist or spine.

Osteoporosis affects men and women of all races, but white and Asian women, especially those who are post-menopausal have the highest risk. This disorder primarily affects middle-aged and elderly people, 80% being women. Older women suffer from osteoporosis more often than men for two reasons: Women’s bones are less massive than men’s, and production of estrogens in women declines dramatically at menopause, but production of testosterone decreases gradually and only slightly in older men. Estrogens and testosterone stimulate osteoblast activity and synthesis of bone.

Risk factors

By Mayo Clinic Staff

A number of factors can increase the likelihood that you'll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.

Some risk factors for osteoporosis are out of your control, including:

• Your sex. Women are much more likely to develop osteoporosis than are men.
• Age. The older you get, the greater your risk of osteoporosis.
• Race. You're at greatest risk of osteoporosis if you're white or of Asian descent.
• Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father experienced a hip fracture.
• Body frame size. Men and women who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age.

Hormone levels

Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:

• Sex hormones. Lowered sex hormone levels tend to weaken bone. The reduction of estrogen levels at menopause is one of the strongest risk factors for developing osteoporosis. Women may also experience a drop in estrogen during certain cancer treatments. Men experience a gradual reduction in testosterone levels as they age. And some treatments for prostate cancer reduce testosterone levels in men.
• Thyroid problems. Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
• Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.

Dietary factors

Osteoporosis is more likely to occur in people who have:

• Low calcium intake. A lifelong lack of calcium plays a major role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
• Eating disorders. People who have anorexia are at higher risk of osteoporosis. Low food intake can reduce the number of calories and amount of protein and calcium ingested. In women, anorexia can stop menstruation, leading to weaker bones. In men, anorexia lowers the amount of sex hormones in the body and can weaken bone.
• Gastrointestinal surgery. A reduction in the size of your stomach or a bypass or removal of part of the intestine limits the amount of surface area available to absorb nutrients, including calcium.

Steroids and other medications

Long-term use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process. Osteoporosis has also been associated with medications used to combat or prevent:

• Seizures
• Gastric reflux
• Cancer
• Transplant rejection

Lifestyle choices

Some bad habits can increase your risk of osteoporosis. Examples include:

• Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem particularly helpful.
• Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis.
• Tobacco use. The exact role tobacco plays in osteoporosis isn't clearly understood, but it has been shown that tobacco use contributes to weak bones.