1.What is osteoporosis? Osteoporosis is a systemic bone disease in which bone mass decreases and bone tissue structure deteriorates due to various causes, resulting in increased brittleness of bones and susceptibility to fracture. Generally speaking, it is a common phenomenon that bone loss occurs with increasing age, but it becomes a disease when bone loss is so great that fractures are likely to occur. 2.What are the categories of osteoporosis? Osteoporosis is divided into three categories: (1) primary osteoporosis, which is osteoporosis due to menopause or old age, and is also divided into type I – postmenopausal osteoporosis and type II – senile osteoporosis, which is the most common type of osteoporosis, accounting for more than 95% of all osteoporosis, with the vast majority occurring in the elderly. (2) Secondary osteoporosis, which refers to osteoporosis caused by certain congenital (genetic) or acquired diseases, the use of certain drugs, braking and other causes. (3) Idiopathic osteoporosis refers to osteoporosis of unknown origin that occurs in adolescents or young people. 3.Who can get osteoporosis? Anyone can develop osteoporosis. However, some people are more prone to develop osteoporosis. It is generally believed that age, gender and race can affect the occurrence of osteoporosis. For example, postmenopausal women are more likely to develop the disease than men of the same age; the prevalence is lower in Africans than in Asians and Europeans. On an individual basis, family history of osteoporosis, low body weight, unbalanced nutritional status, poor lifestyle (e.g., sedentary, lack of exercise, reduced sun exposure, smoking), substance abuse, and early menopause or amenorrhea in women are all high risk factors for the development of osteoporosis. 4.What are the manifestations of osteoporosis? In the early stage of the disease, there is often only weakness, back and limb pain and discomfort, which usually does not attract the attention of patients; with the development of the disease, there can be obvious bone pain, short height, hunchback, tooth loss, reduced mobility, and even fractures. 5.What are the consequences of osteoporosis? The most common consequence of osteoporosis is fracture. According to statistics, about 20% of patients with hip fracture die within one year, and 50% are disabled for life and cannot take care of themselves. Not only does it seriously affect the quality of life of patients and bring unbearable pain, but it also costs a lot of medical expenses, which brings a huge economic burden to the society and families. Vertebral compression fractures of the spine are also very common in elderly patients with osteoporosis, but the diagnosis and treatment are often delayed because they are not given enough attention. 6.How to check whether I have osteoporosis? The diagnosis of osteoporosis is made by testing bone density. At present, the commonly used methods of bone density examination are dual-energy X-ray absorptiometry (DXA for short) and quantitative CT bone density testing (QCT for short), the former costs about 180 yuan and the latter about 400 yuan, and the dose of X-ray exposure received during the examination is much smaller than that of ordinary photographs. Although ordinary X-ray radiographs can indicate the presence or absence of bone loss and are also of great value in diagnosing fractures in various parts of the body, when the manifestation of existing osteoporosis is found on ordinary X-ray plain films, they are all very serious and therefore cannot be used to diagnose osteoporosis. 7.How to prevent osteoporosis? The prevention of osteoporosis should start from infancy and childhood to ensure high quality bone growth and development. In adulthood and old age, more attention should be paid to bone health to reduce bone loss. This includes adequate intake of calcium and vitamin D, good nutritional balance, regular exercise, adequate sunlight exposure, smoking cessation, and no drug abuse. People with high risk factors for osteoporosis should have their bone density tested regularly (annually or every two years) and take medications to prevent osteoporosis under the guidance of a physician if necessary. The elderly should receive proper exercise instruction and take various measures to prevent falls to avoid osteoporotic fractures. 8.Can calcium supplementation cure osteoporosis? Calcium is the most abundant element in bones, and calcium supplementation is a necessary measure to prevent and treat osteoporosis, but for the treatment of osteoporosis, calcium supplementation alone is absolutely insufficient. The currently accepted treatment plan for osteoporosis is based on calcium and vitamin D, plus at least one anti-osteoporosis drug. 9.What are the commonly used anti-osteoporosis drugs? The commonly used anti-osteoporosis drugs include: (1) diphosphonates (Fosamax, TENCO, etc.); (2) calcitonin (MIGA, Ecalcitonin, etc.); (3) selective estrogen receptor modulators (Evident); (4) hormone replacement therapy (HRT); and (5) recombinant human parathyroid hormone (PTH). As mentioned earlier, the treatment regimen is usually one of calcium and vitamin D and anti-osteoporosis drugs, which need to be used under the supervision of a specialist. 10.How can I know if the treatment for osteoporosis is working? The treatment of osteoporosis is a long-term process, and the measurement of bone density is the main method to determine the effectiveness of treatment, and it often takes six months after the treatment to see the obvious effect. Of course, the occurrence of fractures is also an intuitive way to determine the efficacy of osteoporosis treatment, but it is only suitable for use in population studies. 11.Is it too late to start treatment now that a fracture has already occurred? It is never too late to mend. This is also true for osteoporosis. Even in very severe cases, starting treatment at any time will be effective. Aggressive treatment can prevent and reduce the occurrence of re-fractures, not only by reducing pain and improving quality of life, but also by preventing the patient from incurring medical expenses due to re-fractures and greatly reducing medical costs in general.