Causes of secondary osteoporosis: Third stage endocrine center experience

Purpose: In this study, it was aimed to investigate the causes of secondary osteoporosis among adult patients whose bone mineral density was evaluated for any reason in a tertiary center. Methods: This retrospective study was conducted among the patient population who applied to all units of Dicle University Hospitals between January 1, 2019 and December 31, 2021 and whose bone mineral density was checked for any reason, and those aged between 18-50 years and those who met the definition of secondary osteoporosis with a Z score < -2.0 SD. will be made with patients. Patients whose secondary osteoporosis causes were fully examined from the patient files will be included in the study. Statistical analyzes of the data were performed. Result: A total of 5688 DEXA reports were reviewed, and the age of 1686 patients was found to be between 18-50. 245 patients met the definition of secondary osteoporosis. 184 patients with complete data were included in the study. Of 184 patients included in the study, 77 (41.8%) were male, and 58.2% of 107 patients were female. While the mean age of male patients was 31.4; The mean age of female patients was 30.6 years. In the statistical analysis performed with the Z score between men and women, the Z score of men was found to be lower (p<0.01). While the mean Z score of men was 3.4, this value was -2.98 in women. Steroid 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% malabsorption, 2.7% parathyroid adenoma were found as etiology in the patient. When the mean Z scores of common causes of secondary osteoporosis were examined, it was found that patients with parathyroid adenoma with a Z Score of -4.0 had the lowest, and patients with a diagnosis of vitamin D deficiency, pituitary insufficiency and idiopathic osteoporosis with the highest Z score of -2.8. Conclusion: In the adult population with osteoporosis, one in seven patients has secondary osteoporosis. Secondary osteoporosis is more common in women. Men's bone mineral density is worse than women's. Etiological causes were determined as hypogonadotropic hypogonadism, thalassemia, celiac disease and steroid use, respectively, in order of frequency. Z score is lowest in patients with parathyroid adenoma and osteogenesis imperfecta. Key words: Secondary osteoporosis; Adult, Bone mineral density