How to manage osteoporosis before the age of 50
S Rozenberg1, O Bruyère2, P Bergmann3
1Department of Gynaecology-Obstetrics, CHU St Pierre, Université Libre de Bruxelles, Brussels, Belgium.
Maturitas
|July 8, 2020
Summary
Managing osteoporosis in young adults (<50) requires careful diagnosis, excluding secondary causes. Lifestyle and targeted treatments are key for bone health in this age group.
Area of Science:
- Endocrinology
- Bone Metabolism
- Gerontology
Background:
- Osteoporosis management guidelines primarily focus on older adults.
- Young adults (<50) with low bone mineral density (BMD) may not have osteoporosis.
- Idiopathic osteoporosis in young adults is rare and heterogeneous, often linked to reduced osteoblast function.
Purpose of the Study:
- To review the diagnosis and management of osteoporosis in patients under 50.
- To highlight challenges in diagnosing and treating young adults with osteoporosis.
- To discuss specific considerations for osteoporosis in young men and patients with diabetes.
Main Methods:
- Narrative review of current literature on osteoporosis in young adults.
- Discussion of diagnostic criteria and differential diagnoses.
- Analysis of treatment strategies, including lifestyle, supplements, and pharmacotherapy.
Main Results:
- No established evidence-based treatment recommendations exist for osteoporosis in young adults.
- BMD determination is crucial for premenopausal women with fragility fractures or secondary causes.
- Secondary causes like hypogonadism in men and diabetes require specific management approaches.
Conclusions:
- Diagnosis in young adults necessitates excluding secondary causes and avoiding unnecessary treatment.
- Adequate calcium, vitamin D, and healthy lifestyle are foundational.
- Targeted therapies, including antiresorptives and hormone replacement, are reserved for specific high-risk cases.
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