gms | German Medical Science

Objectives: Osteoporosis is a disease usually associated with postmenopausal women and men over sixty. Little is known about the long-term course of young osteoporosis and the factors affecting treatment and T-score over time.

Factors that cause or promote osteoporosis and its progression in younger patients are less extensively studied than in older patients, and data are lacking for the continuation of treatment over time. Our study group pursues this topic in the current follow-up of the project Register Junge Osteoporose.

Methods: Women 50 years or younger and men 60 years or younger at the time of diagnosis were recruited into the register of 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-score values 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 and conclusion: 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 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, 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).

Conclusion: 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.