Refers to a T score bone mineral density higher than -2.5 but less than -1.0.

Estimated to affect more than 33.6 million Americans with 80% women.

Refers to a condition in which bone mineral density is lower than normal.

Considered by many doctors to be a precursor to osteoporosis.

Not every person diagnosed with osteopenia will develop osteoporosis.

Like osteoporosis, osteopenia occurs more frequently in post-menopausal women as a result of the loss of estrogen.

Exacerbated by lifestyle factors such as lack of exercise, excess consumption of alcohol, smoking or prolonged use of glucocorticoid medications.

Can also be a result of exposure to radiation.

Osteopenia occurs more frequently in participants in non-weight-bearing sports like bicycling or swimming than in participants in weight-bearing sports like running, since bone-loading exercise tends to protect or possibly increase bone mineral density.

Often present in young female athletes.

It is one of the three major components of female athlete triad syndrome, along with amenorrhea and disordered eating.

Female athletes with a chronic negative energy balance can suppress estrogen levels and decrease bone mineral density.

A sign of normal aging, in contrast to osteoporosis which is present in pathologic aging.

Osteopenia is also a common effect of celiac disease.

The treatment of osteopenia is controversial.

Candidates for therapy include those at the highest risk of osteoporotic bone fracture based on bone mineral density and clinical risk factors.

Bone fractures tend to occur frequently in the much larger group of women with bone mineral density in the osteopenic range than in the osteoporosis range: therefore there are more bone fractures in the osteopenia group than in the osteoporotic group..

Consideration of therapy for postmenopausal women, and men older than 50 years of age, if any one of the following is present:

Prior hip or vertebral fracture

T-score of -2.5 at the femoral neck or spine, excluding secondary causes

T-score between -1.0 and -2.5 at the femoral neck or spine and a 10-year probability of hip fracture ≥3% or a 10-year probability of major osteoporotic fracture ≥20%

Patient preferences for treatment for10-year fracture probabilities above or below these levels.

Treatment includes bisphosphonates including alendronate, risedronate, and ibandronate, selective estrogen receptor modulators (SERMs) such as raloxifene, estrogen, calcitonin, and teriparatide.

The actual benefits of these drugs may be marginal.

In a six year, double-blind trial involving 2000 women with osteopenia at either the total hip or the femoral neck and treated with placebo versus zoledronate: the risk of non-vertebral vertebral fragility fracture was significantly lower in the women with osteopenia who received zoledronic acid then and women who receives the placebo (Reid IR).

Estimated approximately 270 women with osteopenia need to be treated with drugs for three years so that one of them could avoid a single vertebral fracture.

Usually the result of a rate of bone lysis that exceeds the rate of bone matrix synthesis.

Analogous to Prehypertension, borderline elevate cholesterol, and impaired glucose tolerance.

The risk of fracture is greater for osteoporosis, but because there are so many more patients with osteopenia that the number of fractures associated with the latter is higher than the number with osteoporosis.

Prevalence of 38% in men age 50 years and older.

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