TY - JOUR
T1 - Epidemiology and clinical features of osteoporosis in young individuals
AU - Khosla, S.
AU - Lufkin, E. G.
AU - Hodgson, S. F.
AU - Fitzpatrick, L. A.
AU - Melton, L. J.
N1 - Funding Information:
Acknowledgments: This work was supportedi n part by ResearchG rants AC 04875 and AR 30582 from the National Instituteso f Health, United StatesH ealth Service, and by a Marion Merrill Dow Academic Research Transition Award (MARTA) to Dr. SundeepK hosla.
PY - 1994
Y1 - 1994
N2 - Due to the lack of epidemiologic data on osteoporosis in the young, we identified all 22 Olmsted County, MN, residents aged 20-44 years when first diagnosed with established osteoporosis in 1976-1990. The overall age- and sex-adjusted incidence rate was 4.1 per 100,000 person-years (95% CI 2.4-5.9) with a female to male ratio of age-adjusted rates of 1.2:1. The majority represented secondary osteoporosis (12 steroid-induced, 3 postmenopausal, 2 delayed puberty, 2 anticonvulsant-induced, 2 gastrointestinal disease, 2 alcoholism, 1 anorexia nervosa, and 7 other etiologies; some individuals had more than one factor present) but two had idiopathic osteoporosis (incidence 0.4 per 100,000 person-years, 95% CI 0-0.9). To further characterize the patients with idiopathic osteoporosis, we also reviewed the entire Mayo + Clinic experience with such patients from 1976 to 1990, regardless of residency. A total of 56 patients (30 female/26 male) were identified with a median age at diagnosis of 34 years. Only 8% were hypercalciuric at presentation. There was a preponderance of cancellous bone fractures (vertebral 81%, rib 37%, wrist 13%), although 13% did have hip fractures. Transiliac bone biopsies were available in 18 patients. As compared to age- and sex-matched controls, the osteoporotic subjects had a significant reduction in trabecular bone volume, cortical thickness, and mean wall thickness, the latter suggesting an abnormality in osteoblast function in these individuals. These studies, therefore, define for the first time the incidence and etiology of osteoporosis in young individuals and provide further clinical and histomorphometric definition of patients with idiopathic osteoporosis. Our data suggest that impaired osteoblast function may be a common finding in these patients, although the etiology of this abnormality remains to be determined.
AB - Due to the lack of epidemiologic data on osteoporosis in the young, we identified all 22 Olmsted County, MN, residents aged 20-44 years when first diagnosed with established osteoporosis in 1976-1990. The overall age- and sex-adjusted incidence rate was 4.1 per 100,000 person-years (95% CI 2.4-5.9) with a female to male ratio of age-adjusted rates of 1.2:1. The majority represented secondary osteoporosis (12 steroid-induced, 3 postmenopausal, 2 delayed puberty, 2 anticonvulsant-induced, 2 gastrointestinal disease, 2 alcoholism, 1 anorexia nervosa, and 7 other etiologies; some individuals had more than one factor present) but two had idiopathic osteoporosis (incidence 0.4 per 100,000 person-years, 95% CI 0-0.9). To further characterize the patients with idiopathic osteoporosis, we also reviewed the entire Mayo + Clinic experience with such patients from 1976 to 1990, regardless of residency. A total of 56 patients (30 female/26 male) were identified with a median age at diagnosis of 34 years. Only 8% were hypercalciuric at presentation. There was a preponderance of cancellous bone fractures (vertebral 81%, rib 37%, wrist 13%), although 13% did have hip fractures. Transiliac bone biopsies were available in 18 patients. As compared to age- and sex-matched controls, the osteoporotic subjects had a significant reduction in trabecular bone volume, cortical thickness, and mean wall thickness, the latter suggesting an abnormality in osteoblast function in these individuals. These studies, therefore, define for the first time the incidence and etiology of osteoporosis in young individuals and provide further clinical and histomorphometric definition of patients with idiopathic osteoporosis. Our data suggest that impaired osteoblast function may be a common finding in these patients, although the etiology of this abnormality remains to be determined.
KW - Bone histomorphometry
KW - Epidemiology
KW - Idiopathic osteoporosis
KW - Incidence
KW - Osteoblast function
KW - Steroid-induced osteoporosis
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U2 - 10.1016/8756-3282(94)90280-1
DO - 10.1016/8756-3282(94)90280-1
M3 - Article
C2 - 7980966
AN - SCOPUS:0027938476
SN - 8756-3282
VL - 15
SP - 551
EP - 555
JO - Bone
JF - Bone
IS - 5
ER -