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[Osteoporosis--concept, classification and epidemiology]

T Fujita1

  • 1Katsuragi Hospital, Kobe University.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|September 1, 1994
PubMed
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Osteopenia, a decrease in bone mineral density, is often diagnosed as osteoporosis after excluding other conditions. Distinguishing rapid postmenopausal bone loss from lifelong bone loss is crucial for accurate osteoporosis classification.

Area of Science:

  • Endocrinology
  • Gerontology
  • Bone Metabolism

Background:

  • Historically, vertebral fractures were necessary for osteoporosis diagnosis.
  • Osteopenia is now defined by a bone mineral density 2-2.5 SD below peak bone density.
  • Exclusion of other metabolic bone diseases is essential for accurate diagnosis.

Purpose of the Study:

  • To clarify the definition and classification of osteopenia and osteoporosis.
  • To differentiate between primary and secondary osteoporosis.
  • To address confusion in classifying postmenopausal bone loss.

Main Methods:

  • Radiological and biochemical studies to exclude other metabolic bone diseases.
  • Analysis of bone mineral density measurements.
  • Clinical assessment of patient age and potential causes of bone loss.

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Main Results:

  • Most patients with osteopenia, after exclusions, are diagnosed with osteoporosis.
  • Primary osteoporosis affects middle-aged and older adults.
  • Secondary osteoporosis has identifiable causes and can occur at any age.

Conclusions:

  • Estrogen withdrawal in young women is secondary osteoporosis, while similar postmenopausal loss is often primary, causing classification issues.
  • Rapid bone loss post-menopause requires distinction from lifelong bone loss and should not be termed a "type" of osteoporosis.