Co-Morbidities

When two or more diseases occur together they are called co-morbidities. Co-morbidities or their treatments can interact with each other and make the effects of the diseases more severe than they would otherwise be.

Osteoporosis can be a co-morbidity for many other diseases, and in turn many other diseases can amplify the risks associated with osteoporosis. For some co-morbidities the risk of osteoporotic fractures can be greatly increased. Diseases with evidence of such risks include:

► Chronic inflammatory bowel disease (IBD)
IBD is associated with a 42 percent increase in hip fracture risk
Crohn’s disease is also associated with increased fracture risk

► Chronic inflammatory joint disease
Rheumatoid arthritis is associated with increased hip and vertebrae fracture risk, along with overall fracture risk

► Celiac disease
Associated with increased fracture risk in women over 50
Estimated that 75 percent of fractures in celiac patients are related to osteoporosis without severe mineralization disorders

► Breast cancer
Risk of vertebral fracture increases sharply after diagnosis of breast cancer (4.7 times likelier for women with nonmetastatic breast cancer, 22.7 times more likely in women with relapsing breast cancer)
The source of this increased risk is unclear, though the general effects of cancer and cancer treatment are suspected

► Prostate cancer
Certain prostate cancer treatments are associated with bone loss. Overall fracture risk for men on antiandrogen therapy for prostate cancer increased 23 percent in one study.

► Diabetes
Type 1 diabetes is definitively associated with increased hip fracture risk
Evidence remains unclear on associations between type 2 diabetes and fractures

► Depression
Evidence not as definitive as other co-morbidities, but there is generally an increased risk of fracture among people with depression and a possible association between antidepressants and fractures.

► Renal failure
Like depression, renal failure also has conflicting evidence, and we cannot say with certainty that renal failure and fractures are associated. Certain studies indicate they are, but some researchers consider these studies to be flawed.

Source:
David C, Confavreux CB, Mehsen N, Paccou J, Leboime A, Legrand E. “Severity of osteoporosis: what is the impact of co-morbidities?” Joint Bone Spine 77 Supplement 2 (2010): S103-S106.

spacer spacer spacer