Nonendocrine agerelated abnormalities

Although endocrine factors appear to be the major cause of age-related bone loss, there are important non-endocrine factors that also contribute. The level of bone mass present prior to the onset of age-related bone loss is clearly important: those persons who have high levels are relatively protected against osteoporosis whereas those with low levels are clearly at a greater risk. As has been long recognized, there are a number of episodic factors that increase bone loss in some, but not other, members of the ageing population. These include use of certain drugs such as corticosteroids, diseases such as malabsorption, anorexia nervosa and renal hypercalciuria, and behavioural factors such as smoking, alcohol abuse and inactivity — to enumerate but a few. These may make major contributions to fractures in about 40% of men and 20% of women (Riggs et al 1986).

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