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Classification of osteoporosis

 
, medical expert
Last reviewed: 04.07.2025
 
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There is no single classification of osteoporosis, including osteoporosis in childhood. Different approaches to osteoporosis classification reflect different pathophysiological, morphological, and etiological criteria.

In the practical activity of a doctor, the classification of osteoporosis based on the etiopathogenetic principle is most often used. It involves dividing osteoporosis into primary, not caused by any disease, the influence of medications, the external environment, and secondary, including the impact of the listed reasons.

This classification was adopted at a meeting of the Russian Association for Osteoporosis (1997), supplemented by N.A. Korovina et al. (2000). Classification of osteoporosis.

  • Primary osteoporosis.
    • Postmenopausal osteoporosis (type 1).
    • Senile osteoporosis (type 2).
    • Juvenile osteoporosis.
    • Idiopathic osteoporosis.
  • Secondary osteoporosis.
    • Associated with endocrine diseases:
      • endogenous hypercorticism (Itsenko-Cushing's disease and syndrome);
      • thyrotoxicosis;
      • hypogonadism;
      • hyperparathyroidism;
      • diabetes mellitus (type 1);
      • hypopituitarism, polyglandular insufficiency.
    • Associated with rheumatic diseases:
      • rheumatoid arthritis;
      • systemic lupus erythematosus (SLE);
      • ankylosing spondylitis.
    • Associated with diseases of the digestive system:
      • resected stomach;
      • malabsorption;
      • chronic liver diseases.
    • Associated with kidney disease:
      • chronic renal failure;
      • renal tubular acidosis;
      • Fanconi syndrome;
      • phosphate diabetes.
    • Associated with blood diseases:
      • myeloma disease;
      • thalassemia;
      • systemic mastocytosis;
      • leukemia and lymphomas.
    • Associated with other diseases and conditions:
      • immobilization (prolonged bed rest, paralysis);
      • ovariectomy;
      • chronic obstructive pulmonary diseases;
      • alcoholism;
      • nervous anorexia.
      • eating disorders;
      • kidney transplant.
    • Associated with genetic disorders:
      • osteogenesis imperfecta;
      • Marfan syndrome;
      • Ehlers-Danlos syndrome;
      • homocystinuria.
    • Drug-related;
      • immunosuppressants;
      • heparin;
      • aluminum-containing antiacids.
      • anticonvulsant drugs.
      • thyroid hormone preparations.

It should be noted that the introduction and improvement of new methods for diagnosing osteoporosis has made it possible to recognize a decrease in BMD in children with diseases not listed in this classification.

  • For juvenile dermatomyositis, scleroderma (Golovanova N.Yu., 2006).
  • For Crohn's disease, nonspecific ulcerative colitis (Yablokova E.A., 2006).
  • For glomerulonephritis (Ignatova M.S., 1989; Korovina N.A., 2005).
  • • In Shereshevsky-Turner syndrome (Yurasova Yu.B., 2008), etc.

In the structure of osteoporosis in adults, primary (postmenopausal) osteoporosis predominates. In childhood, secondary, drug-induced osteoporosis caused by the use of glucocorticosteroids is most common.

Primary juvenile osteoporosis is diagnosed after excluding the diseases that induce it. It is characterized by a generalized decrease in BMD due to a decrease in the intensity of bone formation.

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