Table 2.
Risk Factors for Osteoporosis and Fractures
| Risk factor | Example |
|---|---|
| Lifestyle factors | Alcohol (≥3 drinks/day) |
| Aluminum (e.g., antacids) | |
| Excess vitamin A | |
| Frequent falls | |
| High caffeine intake | |
| High salt intake | |
| Immobilization (e.g., bedrest) or inadequate physical activity (e.g., behavior) | |
| Low body mass index | |
| Low calcium intake | |
| Tobacco use (active or passive) | |
| Vitamin D insufficiency | |
| Genetic factors | Cystic fibrosis |
| Ehlers-Danlos syndrome | |
| Gaucher disease | |
| Glycogen storage disease | |
| Hemochromatosis | |
| Homocystinuria | |
| Hypophosphatasia | |
| Idiopathic hypercalciuria | |
| Marfan syndrome | |
| Menkes disease | |
| Osteogenesis imperfecta | |
| Parental history of hip fracture | |
| Porphyria | |
| Riley-Day syndrome | |
| Hypogonadal state | Androgen insensitivity |
| Anorexia nervosa and bulimia | |
| Athletic amenorrhea | |
| Hyperprolactinemia | |
| Panhypopituitarism | |
| Premature ovarian failure | |
| Turner syndrome, Klinefelter syndrome | |
| Endocrine disorders | Adrenal insufficiency |
| Cushing syndrome | |
| Diabetes mellitus | |
| Hyperparathyroidism | |
| Thyrotoxicosis | |
| Gastrointestinal disorders | Celiac disease |
| Gastric bypass | |
| Inflammatory bowel disease | |
| Malabsorption | |
| Pancreatic disease | |
| Previous gastrointestinal surgery | |
| Primary biliary cirrhosis | |
| Hematologic disorders | Hemophilia |
| Leukemia and lymphomas | |
| Multiple myeloma | |
| Sickle cell disease | |
| Systemic mastocytosis | |
| Thalassemia | |
| Rheumatic and autoimmune diseases | Ankylosing spondylitis |
| Rheumatoid arthritis | |
| Systemic lupus erythematosus | |
| Miscellaneous conditions and diseases | Alcoholism |
| Amyloidosis | |
| Chronic metabolic acidosis | |
| Congestive heart failure | |
| Depression | |
| Emphysema | |
| End-stage renal disease | |
| Epilepsy | |
| Idiopathic scoliosis | |
| Multiple sclerosis | |
| Muscular dystrophy | |
| Parenteral nutrition | |
| Posttransplant bone disease | |
| Prior fracture as an adult | |
| Sarcoidosis | |
| Medications | Anticoagulants (heparin) |
| Anticonvulsants | |
| Aromatase inhibitors | |
| Barbiturates | |
| Chemotherapeutic agents | |
| Cyclosporine A | |
| Depo-medroxyprogesterone | |
| Glucocorticoids (≥5 mg/day of prednisone or equivalent for ≥3 months) | |
| Gonadotropin-releasing hormone agonists | |
| Lithium | |
| Oral hypoglycemics | |
| Proton pump inhibitors | |
| Tacrolimus | |
| Selective serotonin reuptake inhibitors |
Adapted from the National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation, 2013. All rights reserved.