Secondary osteoporosis: More than what meets the eye

October 9, 2012

An SGH study has revealed that considering all osteoporotic patients as having simple osteoporosis and treating all of them alike by putting them on potent long term medication without finding out the cause of their osteoporosis may be ineffective and in most cases downright harmful.

Secondary is a rather common but lesser known type of osteoporosis that affects men and women of any age. It is caused by certain medical conditions that result in bone loss or interfere with development of peak bone mass. Contributors of secondary osteoporosis include conditions such as hypercalciuria, hyperthyroidism, hyperparathyroidism, vitamin D deficiency and hypogonadism. The study is the first of its kind in South East Asia.

To find out how common these secondary osteoporosis contributors are in our population, a team led by Dr Manju Chandran, Programme Director, Osteoporosis and Unit at SGH, evaluated 400 patients over two years. The study found that almost half of the patients with osteoporosis had one or more secondary contributors. Secondary osteoporosis, if not identified and treated, can lead to devastating consequences both in terms of fractures as well as from the disease that caused the osteoporosis in the first place.

Conditions that contribute to secondary osteoporosis may not be obvious without detailed history taking and laboratory testing. The study revealed that 22 per cent of the patients with a secondary cause had increased calcium in the urine, which in most cases could be attributed to a high salt diet. Another 18.5 per cent had , 10.1 per cent had and nearly 10 per cent of the men had hypogonadism or low sex hormone levels.

"In our study, the prevalence of secondary osteoporosis in men was found to be high, almost 63 per cent. Our recommendation is for all men with osteoporosis to have some basic laboratory testing to look at their levels of , urine calcium, vitamin D, , etc.," said Dr Chandran, who is also Consultant, Department of Endocrinology, SGH and President, Endocrine and Metabolic Society of Singapore.

"For post-menopausal women, laboratory testing may not be feasible or cost effective as post-menopausal osteoporosis is very common. However, directed testing based on their bone mineral density loss can be done to determine the appropriate treatment for these patients. The appropriate treatment for secondary osteoporosis is treating the condition, which caused it in the first place and not antiosteoporosis medicines," Dr Chandran added.

It is estimated that about 55,000 to 60,000 female Singaporeans above the age of 50 suffer from osteoporosis and that excludes men who are also hit by the disease. While secondary osteoporosis may not be completely reversible, the right treatment can halt the progress of and prevent excessive fracturing and in some cases even save the life of the patient.

Explore further: Experts recommend men at risk for osteoporosis undergo bone density testing

Related Stories

Experts recommend men at risk for osteoporosis undergo bone density testing

June 18, 2012
Osteoporosis in men causes significant morbidity and mortality. Today, the Endocrine Society released clinical practice guidelines (CPG) for management of this condition in men. "Osteoporosis in Men: An Endocrine Society ...

High prevalence of bone disease in patients referred for pulmonary rehabilitation

May 20, 2012
There is a very high prevalence of osteopenia/osteoporosis among male patients with pulmonary disease, according to a new study from researchers in California.

The Medical Minute: Osteoporosis prevention and treatment options

May 19, 2011
Osteoporosis is a skeletal disease characterized by low bone mineral density and structural deterioration of bone, leading to bone weakness and increased risk of fracture. Osteoporosis should not be confused with osteoarthritis, ...

New review outlines screening strategies for osteoporosis in young adults

June 19, 2012
Much of the research defining osteoporosis and fracture risk has focused on older adults, i.e. postmenopausal women and men over the age of 50. While older adults are at highest risk of osteoporosis and related fractures, ...

Recommended for you

New cellular approach found to control progression of chronic kidney disease

December 15, 2017
Researchers have demonstrated for the first time that extracellular vesicles - tiny protein-filled structures - isolated from amniotic fluid stem cells (AFSCs) can be used to effectively slow the progression of kidney damage ...

Testing shows differences in efficacy of Zika vaccines after one year

December 15, 2017
(Medical Xpress)—A large team of researchers with members from Harvard Medical School, Walter Reed Army Institute of Research, Bioqual Inc. and MIT has found that the efficacy of the three types of Zika vaccines currently ...

How to regulate fecal microbiota transplants

December 15, 2017
(Medical Xpress)—A small team of researchers at the University of Maryland, some with affiliations to the Veterans Affairs Maryland Health Care System, has written and published a Policy Forum piece in the journal Science ...

Screening could catch a quarter of hip fractures before they happen

December 15, 2017
Community screening for osteoporosis could prevent more than a quarter of hip fractures in older women - according to new research led by the University of East Anglia (UEA).

Urine test developed to test for tuberculosis

December 14, 2017
(Medical Xpress)—An international team of researchers has developed a urine test that can be used to detect tuberculosis (TB) in human patients. In their paper published in Science Translational Medicine, the group describes ...

40 years after first Ebola outbreak, survivors show signs they can stave off new infection

December 14, 2017
Survivors of the first known Ebola outbreak, which occurred in the Democratic Republic of the Congo in 1976, may be key to development of vaccines and therapeutic drugs to treat future outbreaks, according to a new study ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.