Classification of osteoporosis in children and adults.
Population
Classification
Definition
Children
Primary
Low bone mass caused by intrinsic skeletal defects and abnormal composition of bone tissue:
Collagen type I synthesis alteration
Defects of bone mineralization
Osteoblast or osteocyte dysfunction
Idiopathic juvenile
Transitory state of low bone mass of unknown etiology, characterized by pain in the back, hips and/or lower limbs; vertebral and long bone fractures. The onset of symptoms is insidious and starts before puberty. Patients show spontaneous improvement after puberty.
Adults
Idiopathic
Osteoporosis of unknown etiopathogenesis occurring in young men and premenopausal women, might be associated with:
Low peak bone mass
Low nutritional intake
Unhealthy lifestyle
Osteoporosis associated with pregnancy or lactation
Transient osteoporosis of the hip
Primary
Postmenopausal or type I: Characterized by rapid bone loss due to decreased hormone levels following the first 3–5 years after the menopause, affecting trabecular bone and increasing the risk of vertebral fractures.
Senile or type II: Loss of trabecular and cortical bone as part of the physiological aging process.
Children and adults
Secondary osteoporosis
Consequence of a disease or medications that impair bone metabolism or interfere with the absorption of calcium and/or vitamin D:
Chronic inflammatory states
Chronic kidney disease
Post solid organ transplantation
Malabsorption
Neuromuscular diseases
Immobilization
Neoplastic states
Bariatric surgery
Glucocorticoids
Anticonvulsants
Anticoagulants
Gonadotropin-releasing hormone agonists and androgen-deprivation therapy
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