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Joint Bone Spine
Volume 77, n° S2
pages 103-106 (décembre 2010)
Doi : 10.1016/S1297-319X(10)70003-8
Severity of osteoporosis: what is the impact of co-morbidities?

Claire David a, Cyrille B. Confavreux b, Nadia Mehsen c, Julien Paccou d, Ariane Leboime e, Erick Legrand f,
a Service de Rhumatologie, CHU Hôpital Sud, 16, boulevard de Bulgarie, Rennes, France 
b INSERM U831 et Université de Lyon, Service de Rhumatologie, Hospices Civils de Lyon, Lyon, France 
c CHU Pellegrin, Service de Rhumatologie, 1, place Amélie-Raba-Léon, Bordeaux, France 
d Département Universitaire de Rhumatologie, CHU, Hôpital Roger-Salengro, Lille, France 
e Université Paris-Descartes, Hôpital Cochin, Service de Rhumatologie B, 27, rue du faubourg Saint-Jacques, Paris, France 
f Université d’Angers, CHU, Service de Rhumatologie, Inserm U 922, Angers, France 

Corresponding author.

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.

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Keywords : Fractures, Severe osteoporosis, Risk factors, Health conditions, Co-morbidity

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