Osteopenia and Osteoporosis

  • Sharon Beth Rosenberg


Osteoporosis is a term that means “porous bones.” It is a skeletal disease affecting both women and men. Osteoporosis is a condition in which bones have lost minerals especially calcium, making them weaker, more brittle, and susceptible to fractures. Any bone in the body can be affected by osteoporosis, but the most common places where fractures occur are the back (spine), hips, and wrists.


Osteopenia Osteoporosis Low bone density Densitometry BMD DEXA 


  1. 1.
    Cooper C, Atkinson EJ, Jacobsen SJ, et al. Population-based study of survival after osteoporotic fractures. Am J Epidemiol. 1993;137:1001.CrossRefGoogle Scholar
  2. 2.
    Leibson CL, Tosteson AN, Gabriel SE, et al. Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc. 2002;50:1644.CrossRefGoogle Scholar
  3. 3.
    Magaziner J, Lydick E, Hawkes W, et al. Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health. 1997;87:1630.CrossRefGoogle Scholar
  4. 4.
    Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990:45. MlOlGoogle Scholar
  5. 5.
    Riggs BL, Melton LJ 3rd. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone. 1995;17:505S.CrossRefGoogle Scholar
  6. 6.
    Kannus P, Parkkari J, Niemi S, Palvanen M. Epidemiology of osteoporotic ankle fractures in elderly persons in Finland. Ann Intern Med. 1996;25:975.CrossRefGoogle Scholar
  7. 7.
    US Department of Health and Human Services. Bone health and osteoporosis: a report of the surgeon general. Rockville: US Department of Health and Human Services, Office of the Surgeon General; 2004.Google Scholar
  8. 8.
    Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9(8):1137–41.CrossRefGoogle Scholar
  9. 9.
    Nieves JW, Cosman F. Atypical subtrochanteric and femoral shaft fractures and possible association with bisphosphonates. Curr Osteoporos Rep. 2010;8:34–9.CrossRefGoogle Scholar
  10. 10.
    Green J, Czanner G, Reeves G, Watson J, Wise L, Beral V. Oral bisphosphonates and risk of cancer of the oesophagus, stomach and colorectum: case-control analysis within a UK primary case cohort. BMJ. 2010;341:c4444.CrossRefGoogle Scholar
  11. 11.
    Ensrud KE, Ewing SK, Stone KL, Cauley JA, Bowman PJ, Cummings SR. For the study of osteoporotic fractures research group. Intentional and unintentional weight loss increases bone loss and hip fracture risk in older women. J Am Geriatr Soc. 2003;51:1740–7.CrossRefGoogle Scholar
  12. 12.
    Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010.
  13. 13.
    Prince RL, Devine A, Dhaliwal SS, Dick IM. Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med. 2006;166:869–75.CrossRefGoogle Scholar
  14. 14.
    Dawson-Hughes B, Dallal GE, Krall EA, et al. A controlled trial of the effects of calcium supplementation on bone density in postmenopausal women. N Engl J Med. 1990;23:878–83.CrossRefGoogle Scholar
  15. 15.
    Sahni S, Hannan MT, Gagnon D, Blumberg J, Cupples LA, Kiel DP, Tucker KL. Protective effect of total and supplemental vitamin C intake on the risk of hip fracture-a 17-year follow-up from the Framingham osteoporosis study. Osteoporos Int. 2009;20:1853–61.CrossRefGoogle Scholar
  16. 16.
    Lunt M, Masaryk P, Scheidt-Nave C, et al. The effects of lifestyle, dietary dairy intake and diabetes on bone density and vertebral deformity prevalence: the EVOS study. Osteoporos Int. 2001;12:688–98.CrossRefGoogle Scholar
  17. 17.
    Wilsgaard T, Emaus N, Ahmed LA, et al. Lifestyle impact on lifetime bone loss in women and men: the Tromso study. Am J Epidemiol. 2009;169:877–86.CrossRefGoogle Scholar
  18. 18.
    Dook JE, James C, Henderson NK, Price RI. Exercise and bone mineral density in mature female athletes. Med Sci Sports Exerc. 1997;29:291–6.CrossRefGoogle Scholar
  19. 19.
    Verschueren SM, Roelants M, Delecluse C, Swinnen S, Vanderscheren D, Boonen S. Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in post-menopausal women: a randomized controlled pilot study. J Bone Miner Res. 2004;19:343–51.CrossRefGoogle Scholar
  20. 20.
    Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc. 2002;50:905–11.CrossRefGoogle Scholar
  21. 21.
    Krall EA, Dawson-Huges B. Smoking and bone loss among post-menopausal women. J Bone Miner Res. 1991;6:331–8.CrossRefGoogle Scholar
  22. 22.
    Baron JA, Johnell O, Oden A, et al. Smoking and fracture risk: a meta-analysis. Osteoporos Int. 2005;16:155–62.CrossRefGoogle Scholar
  23. 23.
    Tosteson ANA, Grove MR, Hammond CS, et al. Early discontinuation of treatment for osteoporosis. Am J Med. 2003;115:209–16.CrossRefGoogle Scholar
  24. 24.
    McClung M. Bisphosphonates. Endocrinol Metab Clin N Am. 2003;32:253–71.CrossRefGoogle Scholar
  25. 25.
    Black DM, Cummings SR, David B, Karpf DB, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet. 1996;348:1535–41. [FITI trial]CrossRefGoogle Scholar
  26. 26.
    Cummings SR, MD, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the fracture intervention trial. JAMA. 1998;280:2077–2082. [FIT2 trial].Google Scholar
  27. 27.
    Harris ST, Watts NB, Genant HK, et al. Effects of risedronate treatment on vertebral and non-vertebral fractures in women with post-menopausal osteoporosis: a randomized controlled trial. JAMA. 1999;282:1344–52.CrossRefGoogle Scholar
  28. 28.
    Reginster J, Minne HW, Sorenson OH, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) study group. Osteoporos Int. 2000;11:83–91.CrossRefGoogle Scholar
  29. 29.
    Reginster JY, Adami S, Lakatos P, et al. Efficacy and tolerability of once-monthly oral ibandronate in postmenopausal osteoporosis: 2 year results from the MOBILE study. Ann Rheum Dis. 2006;65(5):654–61. [MOBILE trial]CrossRefGoogle Scholar
  30. 30.
    Delmas PD, Adami S, Strugala C, et al. Intravenous ibandronate injections in postmenopausal women with osteoporosis: one-year results from the dosing intravenous administration study. Arthritis Rheum. 2006;54(6):1838–46. [DIVA trial]CrossRefGoogle Scholar
  31. 31.
    Black DM, Delmas PD, Eastell R, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. NEJM. 2007;356(18):1809–22. [HORIZON Pivotal Fracture trial]CrossRefGoogle Scholar
  32. 32.
    Lyles KW, Colon-Emeric CS, Magaziner JS, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357:1799–809. [HORIZON Recurrent Fracture trial]CrossRefGoogle Scholar
  33. 33.
    Neer R, Arnaud C, Zanchetta JR, et al. Recombinant human PTH [rhPTH(l-34)] reduces the risk of spine and non-spine fractures in postmenopausal osteoporosis. NEJM. 2001;344:1434–41. [Fracture Prevential trial]CrossRefGoogle Scholar
  34. 34.
    Lindsay R, Scheele WH, Neer R, et al. Sustained vertebral fracture risk reduction after withdrawal of teriparatide in postmenopausal women with osteoporosis. Arch Intern Med. 2004;164:2024–30. [Fracture Prevential trial follow-up]CrossRefGoogle Scholar
  35. 35.
    Gallagher JC, Genant HK, Crans GG, Vargas SJ, Krege JH. Teriparatide reduces the fracture risk associated with increasing number and severity of osteoporotic fractures. J Clin Endocrinol Metab. 2005;90:1583–7.CrossRefGoogle Scholar
  36. 36.
    Ettinger B, Black DM, Bruce H, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA. 1999;282:637–45. [MORE trial]CrossRefGoogle Scholar
  37. 37.
    Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breat cancer in postmenopausal women: results from the MORE randomized trial. Multiple outcomes of raloxifene evaluation. JAMA. 1999;281:2189–97.CrossRefGoogle Scholar
  38. 38.
    Cummings SR, Martin JS, McClung MR, et al. For the FREEDOM trial. Denosumab for the prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756–65.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sharon Beth Rosenberg
    • 1
  1. 1.Department of Internal MedicineSaint Francis Hospital EvanstonEvanstonUSA

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