Osteoporosis Classifications

Primary Involutional Osteoporosis
Osteoporosis is a progressive disorder that results in decreased bone mass (volume).

1: Postmenopausal Osteoporosis
Occurs mostly in women 51 to 65 years of age. It is caused by increased bone resorption and results in accelerated bone loss. It affects mainly trabecular bone and may result in axial fractures (vertebral bodies).

Type 2: Senile Osteoporosis
Occurs more commonly after 75 years of age and affects both sexes relatively equally. It is caused by decreased bone formation and results in gradual bone loss. It produces pathology in cortical bone mainly and causes appendicular fracture (hips).

Secondary Osteoporosis
It accounts for less than 5% of the cases and occurs at any age secondary to a number of medical conditions. Many of these are endocrine conditions, such as hyperthyroidism, hypogonadism, and Cushing's syndrome.


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Bone Health Panel: Provider Overview

Osteoporosis and Osteopenia

The interplay between bone formation and resorption is a continuous, lifelong process that favors bone formation in the early years of life, leading to a peak bone mass at approximately 20 to 30 years of age. After reaching this peak, total bone mass gradually declines in both men and women. Osteoporosis is defined as a “reduction in bone mineral density, leading to fractures after minimal trauma” and osteopenia as “any decrease in bone mass below the normal”.

Diagnosis of Osteoporosis

Although the pathogenic events involved in the development of osteopenia and osteoporosis are relatively irreversible, early detection and intervention are key to minimizing bone density loss. Traditionally, diagnosis has relied on bone densitometry (mineralized bone mass assay) using radioactive or radiographic techniques performed at a referral facility. Noninvasive methods to estimate bone mineral density are now available to identify high-risk patients who have not yet sustained a fracture. These include a number of specific urinary assays of bone resorption markers. Pyrilinks-D (deoxypyridinoline) is particularly useful because it is specific to bone resorption as opposed to general collagen loss.

Bone Health Panel

The Bone Health Panel utilizes saliva samples to assess pertinent hormone levels, along with a urine sample to assay Pyrilinks-D. Evaluating levels of estradiol, progesterone, testosterone, cortisol, DHEA/DHEA-S and FSH helps to create a more comprehensive picture of factors that underlie bone metabolism. Sample collection does not require laboratory visits or radiation exposure, and costs are considerably less. The markers assessed by the Bone Health Panel provide valuable data that aid in constructing an appropriate plan for patients with or at risk for osteopenia or osteoporosis. Additionally, the Bone Health Panel offers an objective way to monitor the efficacy of bone loss treatment strategies including correction of hormonal abnormalities, vitamin and mineral supplementation, dietary and lifestyle changes, and/or pharmacologic interventions.