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In a study of
over 1600 women, researchers have identified three risk factors that
contribute to high risk of osteoporosis : age, weight, and estrogen use. Older, thin women who
have never take estrogen (in the form of oral contraceptives or hormone replacement
therapy
) are at an increased risk for osteoporosis, compared
to women who do not have these risk factors. Based on the study, the
researchers are recommending that women with any one of these risk factors
be screened for osteoporosis with bone
mineral density tests.
In the study, Louis Weinstein, MD and Brain Ullery,
MD from the Medical College of Ohio in Toledo, had 1610 women complete a
questionnaire to evaluate their risk of osteoporosis. After completing the
questionnaire, each woman underwent a DEXA (Dual Energy X-ray
Absorptiometry)
scan
to determine her bone mineral density. According to the results of the
study, women over age 65 who weighed less than 140 pounds at menopause and
had never used estrogen for more than six months were at the highest risk
of osteoporosis.
The
researchers found that these risk factors—older age, lower body weight,
and lack of estrogen use—contributed to osteoporosis of the spine, hip,
and femoral neck in the women who participated in the study. Of the 1610
women who underwent DEXA scans, 64.7% did not have osteoporosis, 35.3% had
osteoporosis at one or more sites, and 10.4% had osteoporosis at all three
of these sites.
Based
on their research, Dr. Weinstein and his colleagues have created a
mnemonic ABONE to help women and their physicians determine who is at high
risk for osteoporosis. In ABONE, A stands for age, B stands for bulk, and
ONE stands for never estrogens. According to the researchers, if a patient
has one or more of these risk factors, she should be screened for
osteoporosis.
ABONE |
| A = age
(older women are at higher risk of osteoporosis)
B =
bulk (women with lower body weight are at higher risk of
osteoporosis)
ONE =
never estrogens (women who have not used estrogen are at higher risk
of osteoporosis) |
In
addition to the risk factors identified by Dr. Weinstein and his
colleagues, additional risk factors for osteoporosis include:
- Female gender
- Family history of osteoporosis
- Race (Asian and Caucasian women are at greater risk for
osteoporosis)
- Smoking and alcohol use
- Never having children
- History of broken bones
- Certain diseases (such as anorexia (an eating disorder), celiac
disease (an inability to tolerate grain products), diabetes, chronic
diarrhea, or kidney or liver diseases)
- Lack of exercise
- Low
calcium intake as a child or adult
- Certain medications and steriods (such as steroids to treat
asthma and arthritis (such as cortisone and prednisone), high doses of
thyroid hormone, medications used to treat seizures (such as
phenobarbital and phenytoin (trade name Dilantin))
- Osteoporosis is a degenerative bone disease that affects roughly
25 million Americans. Osteoporosis occurs from a decrease in normal bone
density due to the loss of calcium and collagen. A loss of bone density
causes bones to become brittle, and in turn, leads to frequent fractures
and other serious effects. It is estimated that one third of
post-menopausal women have osteoporosis.
Additional Resources and References
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