Risk Factors for Osteoporosis and Fractures
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Until recently, the diagnosis of osteoporosis was made only when the patient presented with painful fractures. Today, with a greater consciousness of health and healthy living, we realise that recognition and avoidance of risk factors can prevent many chronic illnesses. A 50-year-old postmenopausal woman who goes to her physician for a yearly “check-up” expects to have her blood pressure taken, her cholesterol measured and a mammography performed—that is good medical practice. Likewise, she should ask for a bone mineral density measurement to investigate her risk for developing osteoporosis (Fig. 16.1). Results of studies even suggest that low bone mass density is a better predictor of fracture risk than increased cholesterol is of having a heart attack and high blood pressure of having a stroke (Fig. 16.2). We are now aware of many genetic and acquired factors which are responsible for and/or contribute to the development of osteoporoses. Furthermore, a low bone mineral density is associated with a lower risk of breast cancer: stimulating effects of oestrogen on both trabecular bone and mammary cells may be responsible for this correlation. Another study has shown that bone density changes might be related to the progression of atherosclerosis, or vice versa, in haemodialysis patients.