[Epidemiology of bone and joint disease - the present and future - . Risk and prevention/treatment of fractures associated with lifestyle-related diseases].

The risk of osteoporotic fracture is greater in patients with lifestyle-related diseases such as poorly controlled type 2 diabetes mellitus and stage G3 chronic kidney disease (CKD). The Japanese 2011 Guidelines for the Prevention and Treatment of Osteoporosis covered osteoporosis secondary to lifestyle-related diseases as a typical example of secondary osteoporosis, but specific treatment methods for osteoporosis secondary to lifestyle-related diseases have yet to be established. Therefore, treatment currently follows the clinical guidelines for primary osteoporosis. However, reduced bone quality is common in osteoporosis secondary to lifestyle-related diseases and therapeutic intervention should be considered even in patients without bone fracture if bone density is less than 80% that of the young adult mean. It is generally considered that the effectiveness and safety of bisphosphonate and selective estrogen receptor modulators for patients with osteoporosis and type 2 diabetes mellitus or stage G3 CKD are equivalent to those for patients without such lifestyle-related diseases.