Osteoporosis has been recognized by the World He alth Organization as a civilization disease. In the European Union, due to osteoporosis, a fracture occurs every 30 seconds. And they can be easily prevented. It is enough to ensure that the daily diet contains an adequate amount of calcium, vitamin D and protein. Find out what are the causes and symptoms of osteoporosis. What is the diagnosis and treatment of osteoporosis?

Osteoporosis , in other wordsossification of the bonesi, is a disease in which bone tissue is lost, and consequently the frequency of the occurrence of fractures. The most common and earliest are vertebral fractures (compression fractures), of which only 25-30% manifests itself in the form of acute pain. Another particularly dangerous consequence of osteoporosis is the fracture of the proximal end of the femur. As a result, 50 percent. of injured people lose the ability to move independently, and every fifth woman and every third man die in the first year after the fracture.

Already after the age of 30, the process of bone loss in women may begin to prevail over its formation. Despite this, in Poland, as much as 92 percent. women in their 40s ignore this problem and say they don't have osteoporosis.

Osteoporosis is mainly seen as a disease of women, while it also affects men, although less frequently. In the sixth decade of life, there are 5-6 women per sick man, but after the age of 70 this proportion is only 2: 1.

Osteoporosis: types

There are different types of osteoporosis:

  • Type 1 -Postmenopausal Osteoporosis

Postmenopausal osteoporosis affects women in the 5th and 6th decade of life. Its main cause is estrogen deficiency, and the bone loss process is usually quite dynamic. During this period, the most common are radius fractures (wrist or forearm fracture)

  • Type 2 -senile osteoporosis

Senile osteoporosis affects women and men, and bone loss is usually much slower (about 1% per year), the most serious fractures concern the hip vertebrae

  • Type 3 -secondary osteoporosis

Secondary osteoporosis can be caused by other causes (diseases and medications). is about 20 percent. all cases of illness

Osteoporosis:causes and risk factors

Natural processes of weakening bone tissue accelerate calcium deficiency in the body. If we were to cut a bone, its interior would resemble a sponge. That is why this part was called a spongy substance. Compact bone surrounds her. An important component of both parts is the collagen mesh with calcium s alt crystals.

When the collagen network becomes irregular, thin and at the same time the content of calcium compounds in it decreases, it means a decrease in bone mass and the development of osteoporosis (bone thinning). The bone becomes brittle, porous, light. The bone tissue density and its resistance to external factors decrease.

Factors independent of the human are:

  • female
  • age
  • early termination of menstruation (before 40 years of age) - especially when it is the result of removal of the ovaries
  • family predisposition to fractures and osteoporosis
  • some diseases, e.g. thyroid disease, liver disease, kidney disease, bowel disease or joint disease

Factors we can influence:

  • physical activity
  • low calcium diet
  • medications used (steroids, anti-epileptics, sedatives, anti-coagulants)
  • smoking
  • heavy alcohol consumption

These fractures are caused by a minor injury, a fall from the height of your own body ( although 60% of spine fractures caused by osteoporosis occur without any trauma). So if the banal fall from the bed ends in a fracture, it means osteoporosis. Fractures can occur in different bones, the most dangerous being vertebral and hip fractures.

A reduction in the height and / or roundness of the back is sometimes observed. Rapid body weight fluctuations, especially rapid weight loss, can also be disturbing.

See the gallery of 11 photosWorth knowing

When a baby is born, its skeleton weighs approximately one kilogram. Then it grows, strengthens and when we are 20 years old it weighs an average of 15-20 kg. We reach the so-called peak bone mass - the strongest bones - between the ages of 20 and 25. This high level persists for about 10 more years. Then the bones begin to "lose weight", on average almost 1 percent. weight per year (in postmenopausal women 2-3% per year). It is a physiological process and continues until death.

Osteoporosis - symptoms

There are no typical symptoms of osteoporosis before. Unfortunately, very often the first symptom of osteoporosis are fractures that indicate the advancement of the disease.

According to an expertMaria Rell-Bakalarska, MD, PhD, rheumatologist

Osteoporosis is a diseasechronic, which often develops asymptomatically, "robbing" calcium stores from the skeleton at this time. Therefore, it is called the silent bone thief. Unfortunately, the diagnosis is made too late, when the process is already well advanced. Even the first fracture (low-energy fracture, i.e. without trauma, most often as a result of a simple trip), is not always associated with its true cause, i.e. osteoporosis. That is why it is so important to prevent and counteract calcium deficiency, especially among people who are at risk of developing osteoporosis. The basic element of preventive treatment is introducing a he althy, varied diet as soon as possible. Often, however, we do not follow its rules and we do not provide the right amount of calcium with food. Another obstacle may be the impaired absorption of calcium with age. Supplementing calcium deficiencies with an appropriate supply of vitamin D is the basis of prophylaxis and an essential element in the treatment of osteoporosis, if it occurs. It is also worth strengthening the body through physical activity adjusted to the abilities and age. It is also worth assessing whether there are risk factors for the disease in a given case and performing a prophylactic bone density test, i.e. densitometry, especially among postmenopausal women. Diagnosed osteoporosis requires long-term treatment. The decision to choose a drug should always be made jointly by the doctor and the patient.

Osteoporosis - diagnosis

The diagnosis is based on a densitometry test (densitometry), i.e.bone density test.Usually the lumbar spine and / or hip are checked.

The densitometer measures the density (strength) of bones. The result shows whether we are at risk of osteoporosis (the first stage is osteopenia) or whether the process is advanced enough to cause fractures.

  • from 1.0 to -1.0 - norm
  • -1.0 to -2.5 - osteopenia
  • under -2.5 - osteoporosis

If the densitometry result is lower than -1, the doctor will order additional analyzes, incl. blood calcium and phosphorus levels, alkaline phosphatase, ESR, calcium levels in the 24-hour urine collection. After the tests, the specialist selects the appropriate therapy for us.

In recent years, methods assessing the risk of fractures have made a "career". The FRAX method is the most widely used.

Osteoporotic fractures: causes and types. Fracture Risk Assessment in Osteoporosis (FRAX® Calculator)

It allows you to assess (as a percentage) how high the risk of fractures in the next 10 years is. However, the results of such an analysis should not be directly translated intodiagnosis. The diagnosis and the decision to start therapy should always be made individually.

Around the age of 40 densitometry should be performed by anyone at risk. If we are not at risk of osteoporosis, it is worth doing such a prophylactic test: women around 50, men around 60.

Osteoporosis - treatment

Generic bisphosphonates are the most commonly used drugs in the treatment of osteoporosis in Poland. These drugs have an anti-resorptive effect (reducing bone loss).

The condition for the success of the therapy is the correct and regular use of medications as well as recommendations regarding diet and physical activity. The effects can be seen after a few months or even years.

Since 2012, denosumab has also been reimbursed - the first biological drug in the treatment of osteoporosis, in the form of subcutaneous injection, used once every 6 months. This drug is a fully human monoclonal antibody that reduces bone resorption and increases bone mineral density (BMD), which in turn reduces the risk of fracture. However, the refund can only be used by women with osteoporosis who meet all of the following criteria:

  • postmenopausal osteoporosis (Tscore less than or equal to -2.5 as measured by DXA method)
  • in women over 60 years of age
  • with osteoporotic fracture
  • after treatment with oral bisphosphonates has failed or with contraindications (intolerance) to their use

It is also indicated for men with low BMD and high risk of fractures, and can be used in renal failure.

Other treatments available for the treatment of osteoporosis are strontium ranelate but are not reimbursed.

A second-choice treatment that can be used in patients with first-line drugs are contraindicated, physically incapable of adherence to recommendations regarding their intake or in case of poor tolerance. Second choice drugs for the treatment of osteoporosis are raloxifene (reduces the risk of fracture only vertebral bodies) and teriparatide.

Pharmacotherapy is a very important part of treatment, but many other activities must be added, such as diet modification, vitamin D supplementation.

Without proper treatment, the risk of further fractures is 50%.

  • When are you at risk of drug-induced osteoporosis? Causes and treatment of drug-induced osteoporosis
  • The perfect menu for the prevention of osteoporosis
  • Osteoporosis in children: causes and treatment
Important

Osteoporosis - where to find help?

1. European FoundationOsteoporosis and Musculoskeletal Diseases - www.osteoporoza.pl

2. Polish Osteoporosis Foundation -www.pfo.com.pl

Category:

Spine, bones, joints