Osteoporotic Fractures

The grounding supports osteoporosis-related low bone mass and deterioration of bone microarchitecture as the underlying cause of these fractures. In the reviewed literature, diabetes-related metabolic changes and sex-specific factors are also discussed as contributors to osteoporosis and fracture risk, but the fracture itself remains secondary to osteoporosis.

The biological basis is reduced bone density and deterioration of bone microarchitecture, which weakens bone and increases fracture susceptibility. The literature also links impaired osteoblast differentiation, reduced bone formation, and increased osteoclast differentiation to osteoporosis-related bone fragility, including mechanisms involving AGE-RAGE signaling, ferroptosis of osteoblasts, and PPAR-gamma-related effects.

Low bone mineral density and microarchitectural deterioration are the core risk factors for osteoporotic fractures. The supplied reviews also identify postmenopausal status, female sex, sex hormone-related differences, sex chromosome abnormalities, and diabetes-associated metabolic disturbances as factors associated with higher osteoporosis and fracture risk.

Management is described at the level of fracture-risk assessment, prevention and control, and pharmacological treatment of osteoporosis. The reviewed guidance includes bone mineral density measurement, case-finding, monitoring, general management, and pharmacological therapy for people at risk of fractures due to osteoporosis.