Endocrine Abstracts

In young patients osteoporosis is associated with endocrine and inflammatory conditions. Early identification of osteoporosis may reduce later morbidity.

We aimed to establish the aetiology of low bone mineral density (LBMD) in young patients at our centre. We identified risk factors and impact of gender on BMD in a young at-risk cohort.

All patients between 20 and 55 years old who underwent DXA scan between 2004 and 2009 were identified. LBMD was defined as a Z score >2 S.D. below the mean, and osteoporosis as a fragility fracture, or a Z score of <−2 with a recognised risk factor. Statistical significance was accepted at P<0.05.

Four thousand eight hundred and eight (556 men) patients underwent DXA. Five hundred and seventy-two (144 men) patients had a Z score <−2, of whom 502 met the diagnostic criteria for osteoporosis. The most frequent indications for DXA scan were amenorrhoea (237), asthma/COPD (46), steroids (20), inflammatory bowel disease (19), alcohol (17) and rheumatoid arthritis (16). A significantly higher proportion of men referred for DXA had LBMD compared to women (χ², P<0.001). Overall, 93 (33 men) had a Z score <−3.0, for whom the most common indications were amenorrhoea in women and asthma/COPD in men.

Amenorrhoea and inflammatory conditions were the commonest cause of osteoporosis and LBMD in young patients. A higher proportion of men referred for DXA had LBMD, which suggested that osteoporosis was considered later in the course of their disease.