Nihon rinsho. Japanese journal of clinical medicine
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This article reviews the treatment strategy for the secondary osteoporosis excluding those caused by diabetes, CKD, endocrine disorders, or glucocorticoid, which proceeding articles deal with. Among numerous possible causes for such secondary osteoporosis, the author has selected osteogenesis imperfecta (OI), osteoporosis associated with gastrectomy or bariatric surgery, inflammatory bowel diseases (IBD), and chronic obstructive pulmonary disease (COPD). For OI, current standard treatment is bisphosphonates (BPs), of which efficacy for fracture inhibition has recently been of issue. ⋯ PTH, have just been explored. Osteoporosis associated with gastrectomy, bariatric surgery or IBD, have been treated with vitamin D, calcium, and BPs. Despite high fracture rates, there are almost no treatment data for osteoporosis associated with COPD.
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Accumulating evidence has shown that the risk of osteoporotic fracture is increased in patients with type 1 and 2 diabetes mellitus. Measurement of bone mineral density is not a good evaluation tool for diabetes-related osteoporosis because the underlying mechanism is based on the deterioration of bone quality with accumulation of collagen cross-links of advanced glycation end products, decreased bone formation, and cortical porosity. ⋯ However, the evidence of treatments for diabetes-related osteoporosis is not sufficient so far. Therefore, further studies are necessary to solve this issue in future.