Osteoporosis: bone Mass

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Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in men, and may occur in anyone in the presence of particular hormonal
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While osteoporosis occurs in people from all ethnic groups, European or Asian ancestry predisposes for osteoporosis.[4] Those with a family history of fracture or osteoporosis are at an increased risk; the heritability of the fracture as well as low bone mineral density are relatively high, ranging from 25 to 80 percent. There are at least 30 genes associated with the development of osteoporosis.[5] Those who have already had a fracture are at least twice as likely to have another fracture compared to someone of the same age and sex.[6]

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• Excess alcohol - small amounts of alcohol do not increase osteoporosis risk and may even be beneficial, but chronic heavy drinking (alcohol intake greater than 2 units/day),[7] especially at a younger age, increases risk significantly.[8] • Vitamin D deficiency[9] - low circulating Vitamin D is common among the elderly worldwide.[10] Mild vitamin D insufficiency is associated with increased Parathyroid Hormone (PTH) production. [10] PTH increases bone reabsorption, leading to bone loss. A positive association exists between serum 1,25-dihydroxycholecalciferol levels and bone mineral density, while PTH is negatively associated with bone mineral density.[10] • Tobacco smoking - tobacco smoking inhibits the activity of osteoblasts, and is an independent risk factor for osteoporosis.[7][11] Smoking also results in increased breakdown of exogenous estrogen, lower body weight
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