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Many people think osteoporosis is simply linked to old age – the older we get, the more chance we have of developing osteoporosis. While this is true in some ways, age isn’t the only factor involved, and osteoporosis is linked to various other medical conditions, some of which might be surprising. While it’s not certain that people will develop osteoporosis simply because they have these conditions, it is important for individuals to be aware of the increased risk and how other diseases are connected to osteoporosis. Dr Taher Mahmud of the London Osteoporosis Clinic explains more.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease, meaning the body attacks its own cells and tissues. Osteoporosis and rheumatoid arthritis are closely linked, and osteoporosis can be caused by RA in a number of ways. Rheumatoid arthritis has no cure, and is currently treated through management of the symptoms. Chronic inflammation over time has an effect on the body, accelerating bone loss, as do drugs which are used to control the inflammation. Everybody loses bone mass over time, but rheumatoid arthritis speeds up the process and contributes to bone damage, increasing the risk of fracture.

Inflammatory bowel disease & coeliac disease

Inflammatory bowel disease, or IBD, describes a group of intestinal disorders which cause inflammation in the digestive tract. Coeliac disease is a digestive condition in which the small intestine cannot absorb nutrients correctly, caused by an adverse reaction to gluten. IBD and other gastrointestinal diseases have been linked to osteoporosis, through nutritional factors (levels of calcium, vitamin D, and other minerals may not be as high as in those with no intestinal disorder), corticosteroid use over time, and the long-term inflammation.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease, meaning the body attacks its own cells and tissues. Osteoporosis and rheumatoid arthritis are closely linked, and osteoporosis can be caused by RA in a number of ways. Rheumatoid arthritis has no cure, and is currently treated through management of the symptoms. Chronic inflammation over time has an effect on the body, accelerating bone loss, as do drugs which are used to control the inflammation. Everybody loses bone mass over time, but rheumatoid arthritis speeds up the process and contributes to bone damage, increasing the risk of fracture.

Inflammatory bowel disease & coeliac disease

Inflammatory bowel disease, or IBD, describes a group of intestinal disorders which cause inflammation in the digestive tract. Coeliac disease is a digestive condition in which the small intestine cannot absorb nutrients correctly, caused by an adverse reaction to gluten. IBD and other gastrointestinal diseases have been linked to osteoporosis, through nutritional factors (levels of calcium, vitamin D, and other minerals may not be as high as in those with no intestinal disorder), corticosteroid use over time, and the long-term inflammation.

Diabetes

Diabetes is linked to many medical conditions and illnesses, including osteoporosis. Type 1 diabetes is linked to low bone density, and difficulty reaching ideal bone mass. Our bones grow and get stronger until they reach their peak bone mass, so if this is low to begin with, patients have a greater chance of developing osteoporosis or experiencing a fracture. Diabetes is also associated with being overweight, which can contribute to osteoporosis and fracture risk. It is important for diabetes patients to get the correct nutrition and exercise regularly, in order to reduce the risk of osteoporosis and other medical conditions linked with diabetes.

Dementia

Both dementia and osteoporosis are commonly seen conditions in those with old age, but the two are also connected. Those who suffer from dementia run a significantly higher risk of hip fracture than those who have no cognitive disorder. There are many factors which increase the risk of hip fracture, but falls are more common in those with dementia – particularly multiple falls. In those with dementia, the correct care and attention is crucial and can help patients to reduce the risk of fracture.

Chronic kidney disease

Chronic kidney disease, or CKD, describes the gradual loss of kidney function, and is associated with bone disorders and an increased risk of fracture. In those with CKD, fractures in elderly patients are twice as common as in those with normal kidney function.

Hypogonadism

Hypogonadism refers to the decreased function of the gonads, which in men is the testes, and the ovaries in women. This means less oestrogen or testosterone is produced or there is a deficiency in production. Oestrogen deficiency is connected with osteoporosis – menopausal women have been proven to be more at risk – and some studies have shown there is a relationship between testosterone levels and bone density.

COPD (Chronic Obstructive Pulmonary Disease)

Progressive lung diseases such as chronic bronchitis and emphysema fall under the umbrella of COPD, which is a term used to describe various inflammatory airway diseases. Reports have shown that low bone mineral density is prevalent in those with COPD, along with reduced physical activity, and vitamin D insufficiency/deficiency, increasing the risk of both osteoporosis and osteoporotic fracture. In those with COPD, screening is recommended as a routine procedure for earlier diagnosis of osteoporosis and appropriate treatment.

Chronic conditions in childhood

Some of the above conditions can also occur in childhood, such as inflammatory bowel disease, and diabetes. Other chronic conditions such as juvenile arthritis also increase the risk of osteoporosis, either through impact on skeletal health or inability to achieve ideal peak bone mass.

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