(a) What is osteoporosis?
Osteoporosis is the most common bone disease in middle-aged and elderly people. It is a systemic disease characterized by low bone mineral content, destruction of bone structure, reduced bone strength, and susceptibility to fracture. Pain, hunchback, reduced height and fractures are characteristic manifestations of osteoporosis. However, there are many patients with osteoporosis who often do not experience any significant sensation in the early stages of the disease. Osteoporotic fractures are fragility fractures that usually occur after daily weight bearing, activity, bending and falls. Fractures are a direct consequence of osteoporosis, affecting body function in mild cases and causing disability or even death in severe cases. The common fracture sites are the low back, hip and arm.
(B) The dangers of osteoporosis.
Osteoporosis is the fourth most common chronic disease and the most common bone disease in middle-aged and elderly people. It is known as the silent killer. Fracture is a serious consequence of osteoporosis and is often the first symptom and reason for consultation in some patients with osteoporosis. Mortality due to various complications reaches 20-25% within the first year after hip fracture. More than 50% of survivors will have varying degrees of disability. The direct financial burden for a patient with osteoporotic hip fracture is RMB 32,776 per year. The direct economic burden of osteoporotic hip fracture in China is RMB 108 billion per year.
(iii) Etiology of osteoporosis.
Osteoporosis is influenced by both congenital and acquired factors. Congenital factors refer to race, gender, age and family history; acquired factors include drugs, diseases, nutrition and lifestyle. Old age, female menopause, and male hypogonadism are all causes of osteoporosis.
(D) High-risk groups of osteoporosis.
People with the following factors are at high risk for osteoporosis: old age; female menopause; maternal family history (especially family history of hip fracture); low weight; low sex hormones; smoking; excessive alcohol or coffee consumption; low physical activity; calcium and/or vitamin D deficiency in the diet (low light exposure or low intake); diseases affecting bone metabolism; application of drugs affecting bone metabolism.
(E) Prevention of osteoporosis.
People of all ages should focus on the prevention of osteoporosis, and the lifestyles of both infants and young people are closely associated with the occurrence of osteoporosis. The mineral content of the human skeleton reaches its highest level in the 30s, which is medically known as peak bone mass. The higher the peak bone mass, the greater the “bone mineral bank” reserve in the human body, and the more delayed and less severe the onset of osteoporosis in old age. Active improvement of diet and lifestyle and adherence to calcium and vitamin D supplementation in old age can prevent or reduce osteoporosis.
Balanced diet: increase the intake of calcium and moderate amount of protein in the diet and low salt diet. Calcium intake has an irreplaceable role in the prevention of osteoporosis. Smoking, alcohol abuse, excessive intake of caffeine and high phosphorus beverages increase the risk of osteoporosis.
Moderate exercise: human bone tissue is a kind of living tissue, and the activity of muscles in human exercise will keep stimulating bone tissue and make bones stronger. Exercise also helps to enhance the body’s responsiveness, improve balance function and reduce the risk of falls. This makes osteoporosis less likely to occur.
Increase sun exposure: The Chinese diet contains very limited vitamin D. A large amount of vitamin D3 is synthesized by exposure of the skin to ultraviolet light from the sun. Regular exposure to sunlight plays a critical role in vitamin D production and calcium absorption. The average normal person receives at least 20 minutes of sunlight per day.
Tip: Sunscreen and umbrellas also increase the chances of osteoporosis in women. The usual lack of outdoor light, and go out to apply thick sunscreen or use the umbrella, will affect the synthesis of vitamin D in the body.
(F) Early diagnosis and standardized treatment to reduce the harm.
It is better to start treatment at any stage of osteoporosis than not to treat it. Getting formal examination early and standardizing medication can minimize the risk of fracture, relieve bone pain and other symptoms, and improve the quality of life.
Prevention and treatment of osteoporosis need to be carried out under the guidance of a physician, and the prevention and treatment strategy includes two parts: basic measures and medication.
Basic measures include lifestyle modification and basic bone health supplements. Lifestyle modifications include a balanced diet rich in calcium, low in salt and moderate in protein, appropriate outdoor exercise, avoidance of smoking and alcohol abuse, careful use of drugs that affect bone metabolism, and various measures to prevent falls. Basic bone health supplements include calcium and vitamin D. Medications include anti-bone resorption drugs, drugs that promote bone formation, and some drugs with multiple mechanisms. They must be applied under the supervision of a physician.
(vii) Self-testing for people at high risk of osteoporosis.
Tip: People at high risk should go to regular hospitals for osteoporosis testing as early as possible to achieve early diagnosis, prevention and treatment.
The following questions can help in the self-testing of osteoporosis high-risk conditions, and those who answer “yes” to any of them are at high risk and should be seen in a spine clinic.
1. Have you ever injured your bones from a minor bump or fall?
2. Have you been taking hormonal drugs for more than 3 months in a row?
3.Have you lost three centimeters of height compared to your youth?
4.Do you often drink alcohol excessively? (2 times a day, or only 1-2 days a week without alcohol)
5.Do you smoke more than 20 cigarettes a day?
6.Do you often have diarrhea? (caused by celiac disease or enteritis)
7.Have your parents ever had a hip fracture from a minor bump or fall?
8.Ms. answer: Have you been menopausal before the age of 45?
9.Have you ever had no menstruation for more than 12 consecutive months (except during pregnancy)?
10. Men: Do you suffer from impotence or lack of sexual desire?
Hint: Older, lower weight women need to pay particular attention to osteoporosis, doctors often use the term “skinny old lady” to describe such high-risk groups. In addition, lack of exercise, lack of light for young people is also a risk factor for osteoporosis.