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4. Types of Osteoporosis
a. Primary Osteoporosis
Primary osteoporosis occurs in patients, in whom a secondary cause of osteoporosis cannot be identified, including juvenile and
idiopathic osteoporosis. Juvenile osteoporosis usually occurs in children or young adults of both sexes. Idiopathic osteoporosis can be further
subdivided into postmenopausal type I and age-associated or senile type II osteoporosis. Type I osteoporosis occurs in women aged 50-65
Figure II.3 Bone repair process after an osteoporosis fracture
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years and is characterized by a phase of accelerated bone loss in trabecular bone. In this phase, fractures of the distal forearm and
vertebral bodies are common. Postmenopausal bone loss is the results of increased bone desorption or in other term high turnover related to
the reduction of estrogens production. The process of bone loss proceeds much more rapidly after menopause. Approximately 10-15
years after menopause, the initially accelerated bone metabolism normalizes and mainly age-associated processes affect bone mass
evolution Kosmin, 2011. Type II osteoporosis occurs in women and men older than 70
years in their cortical and trabecular bone. In addition to wrist and vertebral fractures, hip fractures are often seen in patients with type II
osteoporosis Kosmin, 2011. Age-related osteoporosis is caused by a decrease in bone production resulting from the deterioration of
osteoblast, occurred in both male and female. b.
Secondary Osteoporosis When osteoporosis occurs as a consequence of a disease or a
drug, it is termed as secondary osteoporosis Roche Diagnostics, 2009. Common causes of secondary osteoporosis are shown in Table II.1.
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Table II.1
Common causes of secondary osteoporosis
Cause Example
Endocrine disease Adrenal insufficiency
Cushing‟s syndrome Hypogonadism
Hyperthyroidism Hyperparathyroidism
Medical disease Renal failure
Chronic liver disease Malabsorption syndromes
Gastric surgery Rheumatoid Arthritis
Drug Glucocorticoids corticosteroid treatment
Ant platelets Heparin, Warferin Ant epilepsy Phenytoin, Phenobarbital
Immunosuppressant Other factor
Nutrition deficiency Cancer and multiple myeloma
Osteogenesis imperfecta Immobility
5. Osteoporosis Fracture
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