Idiopathic and Secondary Osteoporosis in Premenopausal Women

BAGUR A; MASTAGLIA SR; OLIVERI B; MAUTALEN C; GONZALEZ D; SARNACKI E; FERNÁNDEZ MC

Congreso; Meeting America Society for Bone and Mineral Research; 2014

Premenopausal (preMP) osteoporosis (OP) may be idiopathic or due to diseases or treatments that affect bone mineral density (BMD). Aim: To identify the clinical characteristics and the evolution of BMD over two years in women with preMP OP. We reviewed the clinical records of 95 preMP women who were referred during the last 6 years for evaluation of BMD to an Institute of Metabolic Bone Diseases. Patients were either self-referred due to concern for the disease or referred from other physician. We analyzed personal and familiar history of fractures (Fx), BMD, biochemical bone markers, diagnosis and their treatments. BMD was considered normal as a Z score above -2.0 in the lumbar spine and/or total femur. Results: 41 out 95 (43%) were in the BMD osteoporotic values. In 22 out of 41 (54%) a diagnosis of idiopathic or primary (1º) OP was made. Nineteen patients (46%) had secondary (2º) OP due to the following diseases: pregnancy (6), anorexia nervosa (4), celiac disease (2), hypercalciuria (1), 1º hyperparathyroidism (1), hypothalamic amenorrhea (1), glucocorticoid (1), osteogenesis imperfecta (1), excess of T4 (1), and congenital adrenal hyperplasia (1). Two out 22 women (9%) with 1º OP had Fx (1 vertebrae and 1 wrist). Four out 19 women (21%) with 2º OP had Fx at the following site: wrist (1), vertebrae (2), and metatarsal (1). Eleven (50%) of the 1º OP women and 6 (32%) with 2º OP had a familiar history of Fx. Table 1 show the significant differences between 1º and 2º OP. The 1º OP patients received the following treatments: Calcium and vitamin D (Ca+D) (17), bisphosphonate (5). Secondary OP patients received: Ca+D and treatment according to the underlying disease.About fifty percent of preMP women with low BMD were idiophatic standing out less bone formation and vitamin D vs. 2º OP. In a preliminary analysis, follow up of this group showed an increase in bone mass.