Endocrine Abstracts

Background: Osteoporosis is a disease usually associated with postmenopausal women and men over sixty. Little is known about the long-term course of early-onset osteoporosis and the factors affecting fracture risk and bone density(T-score).

Objectives: Factors that cause osteoporosis or aggravate its progression in younger patients are less studied than in older patients. Data are lacking on treatment choice, adherence and effectiveness. Our study group pursues this topic in the current follow-up of the Register Young Osteoporosis.

Methods: Women ≤50 yrs. and men ≤60 yrs. at the time of diagnosis who presented to our outpatient clinic, were recruited into the Register Young Osteoporosis, a sub-register of the German Osteoporosis register in cooperation with the DVO (Dachverband Osteologie e.V). After written informed consent, information about bone mineral density (BMD), fractures, personal medical and family history were recorded in the register. For the follow-up, a questionnaire on the course of osteoporosis and its management (BMD, fractures, osteoporosis medication, risk factors) was sent to patients with records of at least 2 DXA-measurements. T-scores of participants who had been followed for at least 3 years were analyzed for change over time in relation to sex, medication use, fracture history, weight and (in women) menopause.

Results: 72 (54,96%) out of 131 responded to the questionnaires, 46 (63,89%) women and 26 (36,11%) men. At the time of diagnosis, mean age was 35±8 years in women and 47±11 years in men. Vitamin D supplementation was associated with an increase in lumbar spine (LS) T-scores in both men (P=0,031) and women (P=0,050). 19/26 men received specific osteoporosis medication, they had lower baseline T-scores (LS:-3,1, total hip(TH):-2,0) than those who did not. 23/26 men had a positive fracture history. A significant improvement in LS T-scores (P=0,045) was seen in men who received medication. Average baseline T-score in women with osteoporosis medication was LS:-2,8, TH:-2,0. 34/46 women had a positive fracture history. Those who received medication had lower T-scores (LS:-2,8, TH:-1,9) than fractured women who didn´t. Premenopausal women (30/46) presented a higher increase in LS T-scores (P=0,041), compared to postmenopausal women (16/46). Premenopausal women showed a significant increase in LS T-scores (P=0,015). A significant decrease in TH T-scores (P=0,006) was seen in underweight women (BMI <18,5).

Conclusions: Vitamin D supplementation, osteoporosis medication, as well as fracture history, weight and (in women) menopause are influential in the management of young osteoporosis patients. Multicentre participation in the registry should be enhanced.