Severity of osteoporosis: what is the impact of co-morbidities?

The co-morbidity profile varies widely across postmenopausal women with osteoporosis and co-morbidities often adversely affect the management of osteoporosis There is a need for detailed information on the co morbidities that may affect the course of osteoporosis by increasing the risk of subsequent fractures or inducing multiple fractures WE consequently reviewed the literature on the most common co-morbidities in adults older than 50 years of age with special attention to published meta analyses We found that osteoporosis severity was increased not only by conventional risk factors but also by a number of conditions including inflammatory bowel and joint diseases with or without glucocorticoid therapy breast cancer and prostate cancer treated with chemotherapy or hormone therapy diabetes (chiefly type 1) and celiac disease Studies suggest an adverse impact of moderate renal failure and depression although their methodological weaknesses preclude definitive conclusions In practice these co-morbidities should be taken into account when evaluating the fracture risk and making treatment decisions (C) 2010 Societe francaise de rhumatologie Published by Elsevier Masson SAS All rights reserved