Secondary Causes of Osteoporosis: Tertiary Endocrine Center Experience

Objectives: The aim of this study was to investigate the causes of secondary osteoporosis in tertiary endocrine center. Methods: This retrospective study consisted of patients applying to tertiary endocrine center between January 1, 2019 and December 31, 2021 whose bone mineral density has been examined for any reason, as well as patients aged 18-50 who are suspected of secondary osteoporosis with a Z score of-2.0 SD or below.
Results: There were 5688 DXA reports screening, and 1686 were between the ages of 18 and 50. The study included 184 patients with complete data. There was a mean age of 30.9 years. The majority of the patients were males (58.2%). Men's Z score was found to be lower (-3.4 vs-2.98) (p<0.01). Steroid use was the most common cause of drug-induced osteoporosis. Vitamin D level was <30 ng/ml in 73.9% of patients with secondary osteoporosis. When the study patients were evaluated in terms of secondary etiologies, hypogonadism 12%, thalassemia 10.9%, gluten enteropathy 9.8%, steroid use 8%, 7.6% connective tissue diseases, 7.1% hypercalciuria, 7.1% idiopathic, 4.9% vitamin D deficiency, 3.8% cachexia, 2.7% parathyroid adenoma were found as etiology in the patient.
Conclusion: Secondary osteoporosis is more common in men. Men's bone mineral density is worse than women's. Etiological causes were determined as hypogonadotropic hypogonadism, thalassemia, celiac disease, and steroid use, respectively. Steroid use was the most common cause of drug-induced osteoporosis. About three-quarters of patients with secondary osteoporosis do not have enough vitamin D.