Osteoporosis is a disease in which increased bone weakness increases the risk of fractures. That is the most common reason for fractures among parents. Commonly ruptured bones include the spine in the spine, the forearm bone, and the hip. Until a fracture occurs there is usually no symptoms. The bone may weaken to such an extent that the break can occur with little stress or spontaneity. Chronic pain and decreased ability to perform normal activities can occur after fractures.
Osteoporosis may be caused by lower than normal bone mass and larger than normal bone. Bone loss increases after menopause due to lower estrogen levels. Osteoporosis can also occur due to a number of illnesses or treatments including alcoholism, anorexia, hyperthyroidism, kidney disease, and ovary removal surgery. Certain drugs increase the rate of bone loss including some anti-seizure medications, chemotherapy, proton pump inhibitors, selective serotonin reuptake inhibitors, and glucocorticosteroids. Smoking and too little exercise are also risk factors. Osteoporosis is defined as bone density of 2.5 standard deviations below the age of young adulthood. This is usually measured by dual energy X-ray absorptiometry in the hip.
Prevention of osteoporosis includes proper diet during childhood and efforts to avoid the drugs that cause the condition. Efforts to prevent fractures in those with osteoporosis include a good diet, exercise, and prevention falls. Lifestyle changes such as quitting smoking and not drinking alcohol can help. Biphosphonate drugs are useful in those who had previous fractures due to osteoporosis. In those with osteoporosis but none of their previous fractures were less effective. A number of other medications may also be useful.
Osteoporosis is becoming more common with age. Approximately 15% of whites in their 50s and 70% of those over 80 years of age are affected. This is more common in women than men. In developed countries, depending on the method of diagnosis, 2% to 8% of men and 9% to 38% of women are affected. The rate of illness in developing countries is unclear. About 22 million women and 5.5 million men in the European Union had osteoporosis in 2010. In the United States in 2010 about eight million women and one to two million men suffered from osteoporosis. Whites and Asians are at greater risk. The word osteoporosis comes from the Greek term for "porous bone".
Video Osteoporosis
Signs and symptoms
Osteoporosis itself has no symptoms; The main consequence is an increased risk of fracture. Osteoporotic fractures occur in situations where healthy people usually will not fracture; Therefore they are considered fracture fragility. Typical frail fractures occur in the spine, ribs, hips and wrists.
Fracture
Fractures are the most dangerous aspect of osteoporosis. Weakening of acute and chronic pain in the elderly is often associated with fractures of osteoporosis and can lead to further disability and premature death. This fracture can also be asymptomatic. The most common osteoporotic fractures are the wrists, spine, shoulders and hips. Symptoms of vertebral collapse ("compression fracture") are sudden back pain, often accompanied by radicular pain (pain due to nerve root compression) and rarely with spinal cord compression or cauda equina syndrome. Multiple vertebral fractures cause posture to bend, loss of height, and chronic pain with a reduction caused by mobility.
Long bone fractures greatly disrupt mobility and may require surgery. Hip fractures, in particular, usually require rapid surgery, because of the serious risks associated with it, such as deep vein thrombosis and pulmonary embolism, and increased mortality.
The fracture risk calculator assesses the risk of fracture based on several criteria, including BMD, age, smoking, alcohol use, weight, and sex. The recognized calculators include FRAX and Dubbo.
The term "osteoporosis formed" is used when osteoporotic fractures have occurred. Osteoporosis is part of the fragility syndrome.
Falling risk
Increased fall risk associated with aging causes fractures of the wrists, spine, and hips. The risk of falling, in turn, increases because of visual impairment due to any cause (eg glaucoma, macular degeneration), balance disorders, movement disorders (eg Parkinson's disease), dementia, and sarcopenia (age-related skeletal muscle damage). The collapse (temporary loss of postural tone with or without loss of consciousness) leads to significant fall risk; the causes of syncope vary, but may include cardiac arrhythmia (irregular heartbeat), vasovagal syncope, orthostatic hypotension (decreased abnormal blood pressure on standing), and seizures. Eliminating obstacles and loose carpet in the environment can reduce the fall. Those with the previous downfall, as well as those who have a gait disturbance or balance, are most at risk.
Maps Osteoporosis
Risk factors
Risk factors for osteoporotic fractures can be divided between non-modified and (potentially) modified. In addition, osteoporosis is a recognized complication of certain diseases and disorders. The use of drugs in theory can be modified, although in many cases, the use of drugs that increase the risk of osteoporosis may be unavoidable. Caffeine is not a risk factor for osteoporosis.
Many diseases and disorders have been linked to osteoporosis. For some people, the underlying mechanisms affect bone metabolism is very easy, whereas for others the cause is many or unknown.
- Generally, immobilization causes bone loss (following the "use or lose" rule). For example, local osteoporosis may occur after limb immobilization of discontinuous limbs in the cast. It is also more common in people who are active with high bone turnover (eg, athletes). Other examples include bone loss during space flight or in bed-bound or wheelchair people for various reasons.
- Hypogonadal states can cause secondary osteoporosis. These include Turner's syndrome, Klinefelter's syndrome, Kallmann's syndrome, anorexia nervosa, andropause, hypothalamic amenorrhea or hyperprolactinemia. In women, the effect of hypogonadism is mediated by estrogen deficiency. May appear as early menopause (& lt; 45 years) or from prolonged premenopausal amenorrhea (& gt; 1 year). Bilateral oophorectomy (surgical removal of the ovaries) and premature ovarian failure lead to poor estrogen production. In men, testosterone deficiency is the cause (eg, andropause or after surgical removal of the testes).
- Endocrine disorders that can cause bone loss include Cushing's syndrome, hyperparathyroidism, hyperthyroidism, hypothyroidism, type 1 and 2 diabetes mellitus, acromegaly, and adrenal insufficiency.
- Malnutrition, parenteral nutrition and malabsorption can cause osteoporosis. Nutritional and gastrointestinal disorders that can affect osteoporosis include undiagnosed and untreated celiac disease (both symptomatic and asymptomatic), Crohn's disease, ulcerative colitis, cystic fibrosis, surgery (after gastrectomy, intestinal bypass surgery or bowel resection) and disease heavy liver (especially primary biliary cirrhosis). People with lactose intolerance or milk allergies can develop osteoporosis due to dietary restrictions that contain calcium. Individuals with bulimia may also develop osteoporosis. Those with adequate calcium intake may develop osteoporosis because of the inability to absorb calcium and/or vitamin D. Other micronutrient nutrients such as vitamin K or vitamin B 12 may also contribute.
- People with rheumatoid arthritis disorders, ankylosing spondylitis, systemic lupus erythematosus, and juvenile idiopathic polyarthic arthritis are at high risk of osteoporosis, either as part of their disease or due to other risk factors (especially corticosteroid therapy). Systemic diseases such as amyloidosis and sarcoidosis can also cause osteoporosis.
- Kidney insufficiency can cause renal osteodystrophy.
- Hematologic disorders associated with osteoporosis are multiple myeloma and other monoclonal gammopathies, lymphomas, leukemia, mastocytosis, hemophilia, sickle cell disease and thalassemia.
- Some congenital abnormalities have been linked to osteoporosis. These include osteogenesis imperfecta, Marfan syndrome, hemochromatosis, hypophosphatasia (often misdiagnosed), glycogen storage diseases, homocystinuria, Ehlers-Danlos syndrome, porphyria, Menkes syndrome, bullous epidermolysis and Gaucher's disease.
- People with unknown scoliosis of the cause also have a higher risk of osteoporosis. Bone loss may characterize complex regional pain syndromes. It is also more common in people with Parkinson's disease and chronic obstructive pulmonary disease.
- People with Parkinson's disease have a higher fracture risk. This is associated with poor balance and poor bone density. In Parkinson's disease there may be an association between loss of dopaminergic neurons and altered calcium metabolism (and iron metabolism) which causes skeletal and kyphosis.
Drugs
Certain medications have been associated with an increased risk of osteoporosis; only glucocorticosteroids and anticonvulsants are classically related, but evidence appears to be related to other drugs.
- Steroid-induced osteoporosis (SIOP) arises from the use of glucocorticoids - analogous to Cushing's syndrome and involves mainly the axial skeleton. Prescription synthetic glucocorticoid prescription prescription prescription is a major candidate after a long intake. Some professional guidelines recommend prophylaxis in patients taking equivalent to more than 30 mg of hydrocortisone (7.5 mg of prednisolone), especially when this is more than three months. Alternative day use can not prevent this complication.
- Barbiturates, phenytoin, and some other inducing enzyme-antiepileptics - this may speed up vitamin D metabolism.
- L-thyroxine replacement may contribute to osteoporosis, in the same way as thyrotoxicosis. This can be relevant in subclinical hypothyroidism.
- Some drugs induce hypogonadism, eg aromatase inhibitors used in breast cancer, methotrexate and other antimetabolite drugs, progesterone depot and gonadotropin release hormone agonist.
- Anticoagulants - long-term use of heparin is associated with decreased bone density, and warfarin (and associated coumarin) have been associated with an increased risk of osteoporotic fractures in long-term use.
- Proton pump inhibitors - these drugs inhibit gastric acid production; this is considered to interfere with calcium absorption. Chronic phosphate binding can also occur with antacids containing aluminum.
- Thiazolidinediones (used for diabetes) - rosiglitazone and possibly pioglitazone, PPAR inhibitors, have been associated with increased risk of osteoporosis and fractures.
- Chronic lithium therapy has been associated with osteoporosis.
Evolutionary
Age-related bone loss is common among humans because it exhibits less dense bones than other primate species. Because human bones are more porous, the frequency of osteoporosis is severe and fractures associated with osteoporosis are higher. Human susceptibility to osteoporosis is a clear cost but can be justified by the benefits of bipedalism which conclude that this vulnerability is a by-product of it. It has been suggested that porous bone helps absorb the increased stress we have on two surfaces compared to our primate counterparts that have four surfaces to disperse forces. In addition, porosity allows more flexibility and lighter frameworks that are easier to support. One other consideration may be that the current diet has a much lower calcium count than other primate diets or human tetrapedal ancestors that may cause a higher likelihood to show signs of osteoporosis.
Pathogenesis
The underlying mechanism in all cases of osteoporosis is an imbalance between bone resorption and bone formation. In normal bone, remodeling of bone matrix is ​​constant; up to 10% of all bone mass may undergo renovation at any point in time. This process occurs in bone multicellular units (BMU) as first described by Frost & amp; Thomas in 1963. Osteoclasts are aided by transcription factor PU.1 to degrade bone matrix, while osteoblasts rebuild bone matrix. Low bone mass density can occur when the osteoclast lowers the bone matrix faster than the osteoblasts that rebuild the bone.
The three major mechanisms in which osteoporosis develops are inadequate bone mass (the skeleton develops insufficient mass and strength during growth), excessive bone resorption, and inadequate new bone formation during remodeling, possibly because the MSC is biased away from the osteoblasts and toward the marrow adipocyte lineage. The interplay of these three mechanisms underlies the development of fragile bone tissue. Hormonal factors greatly determine the rate of bone resorption; Shortage of estrogen (eg due to menopause) increases bone resorption, as well as decreases new bone deposition that usually occurs in burdened bones. The amount of estrogen needed to suppress this process is lower than that normally required to stimulate the uterus and breast glands. The-shape of the estrogen receptor appears to be the most important in regulating bone turnover. In addition to estrogen, calcium metabolism plays an important role in bone reform, and lack of calcium and vitamin D leads to bone deposition disorders; In addition, the parathyroid glands react to low levels of calcium by secreting parathyroid hormone (parathormone, PTH), which increases bone resorption to ensure adequate calcium in the blood. The role of calcitonin, a hormone produced by the thyroid that increases bone deposition, is less clear and may not be as important as PTH.
The activation of osteoclasts is governed by various molecular signals, in which RANKL (the activator of the kappa-B ligand nuclear factor receptor) is one of the most studied. These molecules are produced by osteoblasts and other cells (eg lymphocytes), and stimulate RANK (nuclear factor receptor activator? B). Osteoprotegerin (OPG) binds RANKL before it has a chance to bind RANK, and thereby suppresses its ability to increase bone resorption. RANKL, RANK and OPG are closely related to tumor necrosis factor and its receptor. The role of the Wnt signaling pathway is recognized, but poorly understood. Production of eicosanoids and local interleukins is considered to participate in bone turnover regulation, and the excessive or reduced production of these mediators may underlie the development of osteoporosis.
The trabecular (or cancellous) bone is a spongy bone at the end of long bones and spine. Cortical bone is the hard outer skin of long bones and long bones. Because osteoblasts and osteoclasts inhabit bony surfaces, the trabecular bones are more active and more subject to bone turnover and remodeling. Not only does bone density decrease, but bone microarchitectures are also disrupted. Weak trabecular bone spikula ("microcracks"), and replaced by weaker bones. The location of common osteoporotic fractures, wrists, hips and spine, has a relatively high trabecular bone to cortical bone ratio. These areas rely on the trabecular bones for strength, so intense remodeling causes this area to degenerate most when remodeling is out of balance. Around the age of 30-35, the loss of the bone of allokan or trabecula begins. Women can lose as much as 50%, while men lose about 30%.
Diagnosis
The diagnosis of osteoporosis can be done using conventional radiography and by measuring bone mineral density (BMD). The most popular method for measuring BMD is dual-energy X-ray absorptiometry.
In addition to abnormal BMD detection, the diagnosis of osteoporosis requires investigation of modifiable causes; This can be done with a blood test. Depending on the possibility of a fundamental problem, investigations for cancer with metastasis to bone, multiple myeloma, Cushing's disease and the above-mentioned causes can be performed.
Conventional radiography
Conventional radiography is useful both by itself and together with CT or MRI, to detect complications of osteopenia (reducing bone mass, pre-osteoporosis), such as fractures; for the differential diagnosis of osteopenia; or for advanced examination in specific clinical settings, such as soft tissue calcification, secondary hyperparathyroidism, or osteomalacia in renal osteodystrophy. However, radiography is relatively insensitive to detect early diseases and requires large amounts of bone loss (about 30%) to be seen in X-ray images.
The main radiographic features of generalized osteoporosis are cortical thinning and increased radiolucency. Often the complications of osteoporosis are vertebral fractures where spinal radiography can assist in diagnosis and follow-up. Vertebral height measurements can be performed objectively using ordinary X-ray films using several methods such as high loss along with area reduction, especially when looking at vertical deformities in T4-L4, or by determining a spinal fracture index that takes into account the number of vertebrae involved. The involvement of multiple vertebral bodies leads to chest spine kyphosis, leading to what is known as the dowager's hump.
X-ray of dual energy
Dual-energy X-ray absorptiometry (DEXA scan) is considered the gold standard for the diagnosis of osteoporosis. Osteoporosis is diagnosed when bone mineral density is less than or equal to 2.5 standard deviations below young age (30-40 years : 58 ), the reference population of healthy adult women. This is translated as a T-score. But because bone density decreases with age, more people become osteoporosis with age. : 58 The World Health Organization has established the following diagnostic guidelines:
The International Society for Clinical Densitometry takes the position that the diagnosis of osteoporosis in men under the age of 50 should not be performed on the basis of densitometric criteria alone. It also states, for premenopausal women, a Z-score (comparison with age group rather than peak bone mass) than the T-score should be used, and the diagnosis of osteoporosis in women should also not be based on densitometric criteria. alone.
Biomarkers
Chemical biomarkers are a useful tool in detecting bone degradation. The cathepsin K enzyme breaks down the collagen type I protein, an important constituent in the bone. The antibodies that are prepared can recognize the resulting fragment, called neoepitope, as a way to diagnose osteoporosis. Increased urinary excretion of C-telopeptides, an I-type collagen splitting product, also serves as a biomarker for osteoporosis.
Other measuring tools
Quantitative computed tomography differs from DXA in that it provides separate estimates of BMD for trabecular and cortical bone and reports the right volumetric mineral density in mg/cm 3 rather than the relative Z score of BMD. Among the advantages of QCT: can be done on axial and peripheral sites, can be calculated from existing CT scans without separate radiation doses, sensitive to changes over time, can analyze areas of any size or shape, exclude irrelevant tissues such as fat, muscle, and air, and does not require knowledge of the subpopulation of patients to create a clinical score (eg Z-score of all women at a certain age). Among the deficiencies of QCT: it requires high doses of radiation compared to DXA, large and expensive CT scanners, and because the practice is less standard than BMD, the results are more dependent on operators. Peripheral QCT has been introduced to improve the limitations of DXA and QCT.
Quantitative ultrasound has many advantages in assessing osteoporosis. Modality is small, no ionizing radiation is involved, measurements can be made quickly and easily, and device costs are low compared to DXA and QCT devices. Kalkaneus is the most common skeletal site for quantitative ultrasound examination because it has a high percentage of trabecular bone that is more frequently replaced than cortical bone, providing early evidence of metabolic changes. Also, the calcaneus is quite flat and parallel, reducing repositioning errors. This method can be applied to children, neonates, and premature babies, as well as adults. Some ultrasound devices can be used on the tibia.
Screening
The US Preventive Services Task Force (USPSTF) recommends that all women aged 65 years or older are screened with bone densitometry. In addition they recommend screening women with increased risk factors that put them at risk equivalent to 65 years. There is not enough evidence to make recommendations about intervals for recurrent screening and appropriate age to stop screening. In men, the danger versus the benefits of screening for osteoporosis is unknown. Prescrire states that the need to test for osteoporosis in those who have never had a previous fracture is unclear. The International Society for Clinical Densitometry, however, suggests BMD tests for men 70 or older, or those who are indicated for risk equals 70 years. A number of tools exist to help determine who is worthy to be tested.
Prevention
The prevention lifestyle of osteoporosis is in many ways the reverse of potentially modifiable risk factors. As tobacco smoking and high alcohol intake have been linked to osteoporosis, smoking cessation and moderation of alcohol intake are usually recommended as a way to help prevent it.
In people with celiac disease, adherence to a gluten-free diet lowers the risk of developing osteoporosis and improves bone density. Diet should ensure optimal calcium intake (at least one gram daily) and measure vitamin D levels is recommended, and to take special supplements if necessary.
Nutrition
Studies on the benefits of supplementation with calcium and vitamin D are contradictory, perhaps because most studies do not have people with low dietary intake. The 2018 review by the USPSTF found low-quality evidence that regular use of calcium and vitamin D supplements (or both joint supplements) did not reduce the risk of osteoporotic fractures in adult men and women living in communities with no history of vitamin D deficiency, osteoporosis, or fractures bone. In addition, the same review found evidence of moderate quality that the combination of vitamin D and calcium supplementation increases the risk for developing kidney stones in this population. Evidence is not enough to determine whether supplementation with vitamin D, calcium, or a combination of both has an effect on cancer risk, cardiovascular disease, or death for any cause. USPSTF does not recommend low-dose supplementation (less than 1 gram of calcium and 400 IU of vitamin D) in postmenopausal women because there seems to be no difference in fracture risk. The 2015 review found little data that calcium supplementation lowers fracture risk.
While some meta-analyzes have found the benefits of vitamin D supplements combined with calcium for fractures, they found no benefit from vitamin D supplements alone.
While supplementation does not seem to affect the risk of death, there is an increased risk of myocardial infarction with calcium supplementation, kidney stones, and stomach problems.
Vitamin K deficiency is also a risk factor for osteoporotic fractures. The gamma-glutamyl carboxylase (GGCX) gene is dependent on vitamin K. The functional polymorphisms in the genes may link variations in bone metabolism and BMD. Vitamin K2 is also used as a treatment tool for osteoporosis and GGCX polymorphisms can explain individual variations in response to vitamin K treatment. Vitamin K supplements may reduce the risk of fractures in postmenopausal women; However, there is no evidence for men.
Physical training
The 2011 review reports the small benefits of physical exercise on postmenopausal bone density. The chances of having a fracture were also slightly reduced (an absolute difference of 4%). People who exercise have on average less bone loss (0.85% in the spine, 1.03% in the hip).
Management
Lifestyle
Weight training and/or strength training exercises to strengthen muscles increase bone strength in those with osteoporosis. Aerobics, weight training, and endurance exercises all maintain or increase BMD in postmenopausal women. Fall prevention may help prevent osteoporosis complications. There is some evidence for special protective hips among those in care homes.
Drugs
Bisphosphonates are useful in reducing the risk of future fractures in those who have already suffered osteoporotic fractures. These benefits are present when taken for three to four years. Different bisphosphonates have not been directly compared, so it is not known whether there is anything better than the other. The fracture risk reduction is between 25 and 70% depending on the bone involved. There are concerns of atypical femur fracture and jaw osteonecrosis with long-term use, but this risk is low. With little evidence of benefits when used for more than three to five years and considering the potential side effects, it may be appropriate to discontinue treatment after this time. One medical organization recommends that after five years of oral treatment or three years of intravenous treatment among those at low risk, bisphosphonate treatment may be discontinued. In those at high risk they recommend up to ten years of oral treatment or six years of intravenous treatment.
For those with osteoporosis but who have no evidence of fractures does not support the reduction of risk of fracture with risedronate or etidronate. Alendronate decreases spinal fracture but has no effect on other types of fractures. Half stop their medication in a year. When on treatment with bisphosphonates, check bone mineral density is not necessary. Another review found tentative evidence about the benefits in men with osteoporosis.
Fluoride supplements do not seem to be effective in postmenopausal osteoporosis, because although increasing bone density, it does not reduce the risk of fractures.
Teriparatide (recombinant parathyroid hormone) has been shown to be effective in the treatment of women with postmenopausal osteoporosis. Some evidence also suggests strontium ranelate is effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Hormone replacement therapy, while effective for osteoporosis, is recommended only in women who also have menopausal symptoms. Not recommended for osteoporosis alone. Raloxifene, while effective in lowering vertebral fractures, does not affect the risk of nonvertebral fractures. And while it reduces the risk of breast cancer, it increases the risk of blood clots and strokes. Denosumab is also effective in preventing osteoporotic fractures but not in men. In hypogonadal men, testosterone has been shown to increase bone quantity and quality, but, in 2008, no study evaluated its effect on fracture risk or in men with normal testosterone levels. Calcitonin is temporarily recommended no longer because of the risk of cancer-related and questionable effects on fracture risk.
Certain drugs such as alendronate, etidronate, risedronate, raloxifene, and strontium ranelate can help prevent osteoporotic fractures in postmenopausal women with osteoporosis.
Prognosis
Although osteoporosis patients have an increased mortality rate due to fracture complications, it is rarely deadly.
Hip fractures may lead to decreased mobility and the added risk of many complications (such as deep vein thrombosis and/or pulmonary embolism, and pneumonia). The six-month mortality rate for those aged 50 years and over after hip fractures is found to be about 13.5%, with a substantial proportion (almost 13%) requiring total assistance to mobilize after hip fracture.
Vertebral fractures, while having a smaller impact on mortality, can cause severe chronic pain from neurogenic origin, which can be difficult to control, as well as deformities. Although rare, multiple vertebral fractures can cause severe humpbacks (kyphosis), the pressure generated on the internal organs can impair a person's ability to breathe.
In addition to the risk of death and other complications, osteoporosis fractures are associated with a decrease in the quality of life associated with health.
This condition is responsible for millions of fractures each year, most involving the lumbar, hip, and wrist vertebrae. Rib fracture fractures are also common in men.
Hip fractures
Hip fractures are responsible for the most serious consequences of osteoporosis. In the United States, more than 250,000 hip fractures each year are caused by osteoporosis. A 50-year-old white woman is estimated to have a lifetime risk of 17.5% of a proximal femur fracture. Incidence of hip fractures increases every decade from sixth to ninth for women and men for all populations. The highest incidence is found in men and women aged 80 and older.
Vertebral fractures
Between 35 and 50% of all women over 50 have at least one vertebral fracture. In the United States, 700,000 vertebral fractures occur each year, but only about one-third are recognized. In a series of 9704 women aged 68.8 years on average studied for 15 years, 324 had suffered vertebral fractures upon entry into the study and 18.2% experienced vertebral fractures, but the risk increased to 41.4% in women who suffered a previous vertebral fracture..
Fracture of the wrist
In the United States, 250,000 fractures of the wrist each year are caused by osteoporosis. Wrist fracture is the third most common type of osteoporotic fracture. The lifetime risk of maintaining Colles fracture is about 16% for white women. By the time a woman reaches the age of 70, about 20% have at least one wrist fracture.
Rib crack
Rib fracture fractures are common in men as young as 35 years of age. It is often overlooked as a sign of osteoporosis, because this man is often physically active and suffers from fractures in the course of physical activity. An example is the falling effect of water skiing or jet skiing. However, a rapid test of individual testosterone levels after a diagnosis of a fracture will easily reveal whether the individual is at risk.
Epidemiology
An estimated 200 million people suffer from osteoporosis. Osteoporosis is becoming more common with age. About 15% of whites are in their 50s and 70% of those over the age of 80 are affected. This is more common in women than men. In developed countries, depending on the method of diagnosis, 2% to 8% of men and 9% to 38% of women are affected. The rate of illness in developing countries is unclear.
There are 8.9 million fractures worldwide per year due to osteoporosis. Globally, 1 in 3 women and 1 in 5 men over the age of 50 will experience osteoporotic fractures. Data from the United States show a decrease in osteoporosis in the general population and in white women, from 18% in 1994 to 10% in 2006. Whites and Asians have a greater risk. People of African descent experience a reduced risk of osteoporosis-related fractures, although they have the highest risk of death after osteoporotic fractures.
It has been shown that latitudes affect the risk of osteoporotic fractures. High latitudes such as Northern Europe receive less Vitamin D through sunlight than those closer to the equator, and consequently have higher fracture rates compared with lower latitudes. For example, Swedish men and women have a 13% and 28.5% risk of hip fracture at age 50, while this risk is only 1.9% and 2.4% in Chinese men and women. Diet can also be a factor responsible for this difference, because vitamin D, calcium, magnesium, and folate are all related to bone mineral density.
About 22 million women and 5.5 million men in the European Union have osteoporosis in 2010. In the United States in 2010 about 8 million women and one to 2 million men suffer from osteoporosis. This places a large economic burden on health care systems because of the cost of treatment, long-term disability, and loss of productivity in the working population. The EU spends 37 billion euros a year on osteoporosis-related health care costs, and the US spends about 19 billion USD each year on health care related costs.
History
The association between age reduction associated with bone density and fracture risk returns at least to Astley Cooper, and the term "osteoporosis" and recognition of its pathological appearance are commonly associated with French pathologist Jean Lobstein. The American endocrinologist, Fuller Albright, associates osteoporosis with a postmenopausal state. Bisphosphonates were discovered in the 1960s.
Anthropologists have studied skeletal remains indicating loss of bone density and associated structural changes associated with chronic malnutrition in the agricultural areas where these people live. "It follows that bone deformation may be associated with their heavy labor in agriculture as well as their chronic malnutrition", causing osteoporosis to be seen when radiographs of the remains are made.
Osteoporosis means "porous bone", from the Greek: ostoun meaning "bone" and "meaning" meaning " pore".
References
External links
- Osteoporosis in Curlie (based on DMOZ)
- Health Material: Osteoporosis - National Institute of Arthritis and Disease Musculoskeletal and Skin
- Osteoporosis - l NIH Osteoporosis and Related Bone Diseases - National Resource Center
- Office of the Surgeon General (2004). Bone Health and Osteoporosis: Report from the Surgeon General . Rockville, MD: US Department of Health and Human Services. PMIDÃ, 20945569 . Retrieved July 18 2016 .
Source of the article : Wikipedia
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