title: Severity of osteoporosis: what is the impact of co-morbidities?
abstract: The co-morbidity profile varies widely across postmenopausal women with osteoporosis, and comorbidities 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.
authors.affiliation: Service de Rhumatologie, CHU Hôpital Sud, 16, boulevard de Bulgarie, Rennes, France.
authors.forename: Claire
authors.initials: C
authors.lastname: David
authors.forename: Cyrille B
authors.initials: CB
authors.lastname: Confavreux
authors.forename: Nadia
authors.initials: N
authors.lastname: Mehsen
authors.forename: Julien
authors.initials: J
authors.lastname: Paccou
authors.forename: Ariane
authors.initials: A
authors.lastname: Leboime
authors.forename: Erick
authors.initials: E
authors.lastname: Legrand
mesh_terms: D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index