Table 2.
| Primary factors of osteoporosis | |
| Nonmodifiable risk factors | |
| Factors | Possible cause/risk |
| Age | Personal history of the previous fracture |
| Gender | Genetic (family history) |
| Ethnicity (Asian and Caucasian) | Caucasian and Asian women are at highest risk |
| Modifiable risk factors | |
| Factors | Possible cause/risk |
| Low levels of physical activity (prolonged immobilization and/or sedentary lifestyle) | Estrogen deficiency (early menopause, prolonged amenorrhea periods) |
| Smoking | Low calcium intake or malnutrition |
| Alcohol consumption (≥ 3 units/day) | Osteoporosis secondary to chronic or consumptive diseases |
| Low weight (< 58 kg or 127 lb) | Chronic glucocorticoid use |
| Drugs used in oncology | |
| Aromatase inhibitors (BC) | Chemotherapy |
| Steroidal (exemestane) | Alkylating agents |
| Nonsteroidal (anastrozole and letrozole) | Anthracyclines and docetaxel |
| GnRH agonists (BC: goserelin and triptorelin) | Doxorubicin and excessive alcohol consumption |
| Selective ER modulators (BC) | 5-Fluorouracil |
| LHRH analogues (goserelin, buserelin, leuprorelin, and triptorelin) | Antidepressants and serotonin reuptake inhibitors |
| LHRH antagonists (goserelin) | Oral antidiabetics (thiazolidinediones) |
| Antiandrogens (enzalutamide, bicalutamide, flutamide, and nilutamide) | |
| Other osteopenizing drugs | |
| Methotrexate | NSAID category drugs |
| Megestrol acetate | Estramustine |
| Platinum compounds | Ifosfamide |
| Cyclophosphamide | Radiotherapy and hypogonadism |
| Interferon alfa | Combination of chemotherapy regimens |
| Cyclosporine | Valproic acid |
|
| |
| Secondary factors of osteoporosis | |
| Amenorrhoea | Malabsorption |
| Long-term or high-dose oral corticosteroid use | Smoking |
| Hyperthyroidism | Female hypogonadism |
| Anorexia nervosa | Male hypogonadism |
| Malignant disease | Hyperprolactinaemia |
| Multiple sclerosis/chronic inflammatory arthritis | Cushing's syndrome |
| Immobilization | Thyroxine treatment |
| Rheumatoid arthritis | Chronic inflammatory bowel disease |
| Myeloma | Excessive alcohol intake |
| Treatments for endometriosis | Chronic liver disease |
Abbreviations: BC, breast cancer; ER, estrogen receptor; GnRH, gonadotropin-releasing hormone; kg, kilograms; lb pounds; LHRH, luteinizing hormone-releasing hormone; NSAIDs, nonsteroidal anti-inflammatory drugs; PC, prostate cancer.