From the National Osteoporosis Foundation (NOF)’s Clinician’s Guide to Prevention and Treatment of Osteoporosis. See reference below.
A lot of factors, shown below, play a part in determining a person’s BMD and risk of fracture. Some of these risk factors are used by the FRAX tool to estimate fracture risk.
Conditions, diseases, and medications that cause or contribute to osteoporosis and fractures
| Lifestyle factors | ||
| Alcohol abuse | Excessive thinness | Excess vitamin A |
| Frequent falling | High salt intake | Immobilization |
| Inadequate physical activity | Low calcium intake | Smoking (active or passive) |
| Vitamin D insufficiency | ||
| Genetic diseases | ||
| Cystic fibrosis | Ehlers-Danlos | Gaucher’s disease |
| Glycogen storage diseases | Hemochromatosis | Homocystinuria |
| Hypophosphatasia | Marfan syndrome | Menkes steely hair syndrome |
| Osteogenesis imperfecta | Parental history of hip fracture | Porphyria |
| Riley-Day syndrome | ||
| Hypogonadal states | ||
| Androgen insensitivity | Anorexia nervosa | Athletic amenorrhea |
| Hyperprolactinemia | Panhypopituitarism | Premature menopause (<40 years) |
| Turner’s and Klinefelter’s syndromes | ||
| Endocrine disorders | ||
| Central obesity | Cushing’s syndrome | Diabetes mellitus (types 1 and 2) |
| Hyperparathyroidism | Thyrotoxicosis | |
| Gastrointestinal disorders | ||
| Celiac disease | Gastric bypass | Gastrointestinal surgery |
| Inflammatory bowel disease | Malabsorption | Pancreatic disease |
| Primary biliary cirrhosis | ||
| Hematologic disorders | ||
| Hemophilia | Leukemia and lymphomas | Monoclonal gammopathies |
| Multiple myeloma | Sickle cell disease | Systemic mastocytosis |
| Thalassemia | ||
| Rheumatologic and autoimmune diseases | ||
| Ankylosing spondylitis | Other rheumatic and autoimmune diseases | |
| Rheumatoid arthritis | Systemic lupus | |
| Neurological and musculoskeletal risk factors | ||
| Epilepsy | Multiple sclerosis | Muscular dystrophy |
| Parkinson’s disease | Spinal cord injury | Stroke |
| Miscellaneous conditions and diseases | ||
| AIDS/HIV | Amyloidosis | Chronic metabolic acidosis |
| Chronic obstructive lung disease | Congestive heart failure | Depression |
| End-stage renal disease | Hypercalciuria | Idiopathic scoliosis |
| Post-transplant bone disease | Sarcoidosis | Weight loss |
| Medications | ||
| Aluminum (in antacids) | Anticoagulants (heparin) | Anticonvulsants |
| Aromatase inhibitors | Barbiturates | Cancer chemotherapeutic drugs |
| Depo-medroxyprogesterone (premenopausal contraception) | Glucocorticoids (≥5 mg/day prednisone or equivalent for ≥3 months) | GnRH (gonadotropin-releasing hormone) agonists |
| Lithium cyclosporine A and tacrolimus | Methotrexate | Parental nutrition |
| Proton pump inhibitors | Selective serotonin reuptake inhibitors | |
| Tamoxifen® (premenopausal use) | Thiazolidinediones (such as Actos® and Avandia®) | Thyroid hormones (in excess) |
References
Osteoporos Int. 2014; 25(10): 2359–2381. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176573/