Osteoporosis (OP), is a systemic bone disease characterized by low bone mass and destruction of bone microarchitecture, leading to increased bone fragility and susceptibility to fracture.
Osteoporosis is a health problem with well-defined pathophysiological, psychosocial and economic consequences. A serious consequence of osteoporosis is the occurrence of osteoporotic fractures, which are fractures that can occur with minor trauma or during daily activities due to a decrease in bone strength.
Causes of osteoporosis.
1. Uncontrollable factors
Age: There is no doubt that the incidence of osteoporosis increases with age.
Gender: women are more prone to osteoporosis after menopause, beyond men of the same age.
Family history: If our father or mother in the family has osteoporosis, we are more likely to develop osteoporosis when we are older.
Skeleton size: People with small skeleton are more prone to osteoporosis in the future, and the size of a person’s skeleton is largely innate.
Second, controllable factors
Low body weight, low sex hormones, smoking, excessive alcohol, coffee and carbonated beverages, etc., lack of physical activity, lack of calcium and/or vitamin D in the diet (low light exposure or low intake), diseases affecting bone metabolism and the application of drugs affecting bone metabolism (see the section on secondary osteoporosis).
Symptoms of osteoporosis
Many patients with osteoporosis often have no obvious conscious symptoms in the early stages, and are often found to have osteoporotic changes only after a fracture has occurred by X-ray or bone density examination.
1.Pain
Patients may have low back pain or peripheral pain, and the pain may increase when the load increases or the activity is limited, and in severe cases, there are difficulties in turning, sitting and walking.
2.Spinal deformation
Severe osteoporosis may result in height shortening and hunchback. Vertebral compression fracture can lead to thoracic deformation, abdominal compression and affect cardiopulmonary function, etc.
3.Fracture
Fracture of the neck of the femur after falling and landing on the buttocks;
Falling down and trying to use your hand to support yourself, the radius fracture;
sneeze, the thoracic vertebrae fracture ……
This is not a joke, this is the most common cause of osteoporosis complicating fractures in the elderly. When osteoporosis occurs in the elderly, the strength and toughness of the bones decline and become very brittle, so it’s okay if you don’t fall, but once you fall, you’re in trouble and very prone to fractures.
Diagnosis of osteoporosis
The common clinical indicators used to diagnose osteoporosis are: the occurrence of brittle fractures and/or low bone density, and there is a lack of clinical means to directly measure bone strength.
1, osteoporotic fracture
It is the ultimate manifestation of the decrease in bone strength, and having a fragility fracture is clinically diagnostic of osteoporosis.
2.Bone mineral density measurement
Bone mineral density (BMD) is the best quantitative index for diagnosing osteoporosis, predicting the risk of osteoporotic fracture, monitoring the natural course of disease and evaluating the efficacy of drug interventions.
(1) Bone mineral density measurement methods
Dual-energy X-ray absorptiometry (DXA) is currently the internationally recognized method of bone density examination, and its measured value is used as the gold standard for the diagnosis of osteoporosis.
(2) Diagnostic criteria
Nowadays, it is usually expressed by T-Score (T-value), that is, T-value ≥ -1.0 is normal, -2.5 < t-value < -1.0 is bone loss.
3.Laboratory tests
Commonly used clinical tests: serum calcium, phosphorus, 25-hydroxyvitamin D and 1,25-bishydroxyvitamin D.