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Endocrine Abstracts (2019) 63 D6.2 | DOI: 10.1530/endoabs.63.D6.2

ECE2019 Debates Should we treat young osteoporotic patients? (2 abstracts)

‘No, we shouldn’t treat young osteoporotic patients’

Barbara Obermayer-Pietsch


Low bone mass and a high fracture risk in young individuals has only recently become a focus of interest in bone research and health care as compared to elderly patients. In fact, according to WHO criteria, ‘osteoporotic’ T-scores in bone mineral density (BMD) below −2.5 can be found in less than 1% of women before menopause, and ‘osteopenia’ as defined by T-scores between −2.5 and −1 in only about 10-15% of a healthy population. However, secondary causes of osteoporosis, such as inflammatory bowel disease, rheumatoid arthritis or coeliac disease have a prevalence of low BMD and/or fragility fractures between 15 and 50%. This is also true for patients with anorexia nervosa or patients on insulin therapy due to type 1 diabetes mellitus. Many other endocrine diseases, neuromuscular or metabolic disturbances and even medications with impact on the musculoskeletal system including anticancer therapy and systemic glucocorticoids have been identified to increase fracture risk. In addition, the perception of bone status or fracture risk among young patients regarding the severity of the disease or the adherence to osteoporosis prevention strategies has been reported to be very low. From a medical perspective, low BMD and/or the occurrence of low trauma or multiple fractures should alert doctors in various fields of medicine to start further investigations of their patients’ bone status. A diagnostic workup should therefore include clinical exams, imaging including DXA and laboratory analyses including bone biomarkers and a large panel of investigations for secondary underlying disorders and/or medications potentially associated with osteoporosis. Therapeutic implications cover lifestyle-associated factors, physical activity for the preservation of muscle and bone mass and adapted nutritional intake. Indications and contraindications of osteotropic therapeutics will be discussed as well as general guidance for young osteoporosis patients.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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