Clinical relation between BPPV and osteoporosis

Abstract

This study was designed to investigate bone mineral density in patients with idiopathic BPPV to determine whether there is a clinical association between etiologically unknown (idiopathic) BPPV and osteoporosis. Dual energy X-ray absorptiometry was used to measure the bone mineral density (BMD) at lumbar vertebrae L2L4 in menopausal women over the age of 50 years who had been diagnosed as having idiopathic BPPV. A BMD value of less than 70% of the young adult mean (YAM) was regarded as indicating the presence of osteoporosis. The overall prevalence of osteoporosis in patients with BPPV was 27.5%, which was almost the same as that in a previously reported national survey. However, the rate of concurrent osteoporosis was higher among patients with recurrent BPPV (38.9%) than among those with non-recurrent BPPV (21.2%). Subjects with recurrent BPPV had a lower BMD (72.4% of the YAM) than those with non-recurrent BPPV. Subjects with multiple occurrences had an even lower BMD (69.4% of the YAM) and were classified as having osteoporosis. Thus, BPPV and osteoporosis may have similar pathogenetic mechanisms associated with calcium metabolism in both otoconia and bone. These results suggest that idiopathic BPPV with osteoporosis may be capable of recurring.