Risk Factors

A woman may have many risk factors

Because osteoporotic fractures often occur without prior warning, it can be difficult to guard against the development of osteoporosis.1 Many people may not be diagnosed in time to receive appropriate therapy.

The National Osteoporosis Foundation (NOF) generally recommends that all postmenopausal women and men older than 50 should be checked for osteoporosis and fracture risk.1

This evaluation involves determining whether someone has any of the risk factors associated with osteoporosis and fracture. A person who has more of these factors than others has a higher risk of fracture.1 Risk factors include:

  • Lifestyle factors, such as low calcium intake, high caffeine or salt intake, and smoking
  • Genetic factors, including parental history of hip fracture and cystic fibrosis
  • Hypogonadal states, caused by dysfunction of the male or female sex organs—for example, premature ovarian failure and anorexia nervosa
  • Endocrine disorders, which are related to certain glands that produce hormones, such as diabetes
  • Gastrointestinal (GI) disorders, such as celiac disease (a digestive disorder that affects how nutrients are absorbed) and inflammatory bowel disease (a disorder in which the bowels become inflamed)2
  • Hematologic disorders, which are related to the blood—such as hemophilia and leukemia, a bone marrow disease
  • Rheumatic disorders (related to the joints, muscles, tendons, bones, and nerves) and autoimmune disorders (conditions in which the body reacts to its own immune system)—for example, lupus and rheumatoid arthritis
  • Other miscellaneous conditions, such as alcoholism and epilepsy

Using WHO risk factors to identify osteoporosis

Aside from these criteria, the World Health Organization (WHO) has developed a way to assess osteoporosis to help doctors determine whether people are at risk of fracture.1 Many risk factors are included in the WHO model, which spans the following factors:1

  • Current age
  • Gender
  • Prior osteoporotic fracture
  • Bone mineral density (BMD) in the femoral neck (the area of bone that connects the shaft and the head of the thigh bone)3
  • Low body mass index
  • Rheumatoid arthritis
  • Secondary osteoporosis
  • Parental history of hip fracture
  • Current smoking
  • Excessive alcohol intake
  • Glucocorticoids usage

The presence of these risk factors can indicate an increased risk for osteoporosis, regardless of BMD.1 Evaluating these particular factors as well as BMD can help determine each person’s future fracture risk.

  • 1. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2010.
  • 2. Womenshealth.gov [Internet]. Inflammatory bowel disease fact sheet. US Department of Health and Human Services, Office on Women’s Health; [cited 2012 Jun 16]. Available from: http://www.womenshealth.gov/publications/our-publications/fact-sheet/inf...
  • 3. World Health Organization [Internet]. WHO Scientific Group on the Assessment of Osteoporosis on the Primary Care Level: Summary Meeting Report; 2004 May 5-7; Brussels, Belgium; [cited 2012 Aug 13]. Available from: http://www.who.int/chp/topics/Osteoporosis.pdf.

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