Osteoporosis (OP) is a disease of systemic bone loss, destruction of bone tissue microstructure, increased bone fragility and susceptibility to fracture, which has jumped to the 7th place of various common diseases as the global aging continues to increase, and its incidence is 22.6% in people over 60 years old in China, 15% in men and 28.6% in women, known as The “silent killer”. 1, classification Osteoporosis is divided into primary and secondary, the former has been divided into two categories related to the lack of menopausal estrogen and aging, postmenopausal bone cancellous loss for type 1 osteoporosis, age-related bone cortical and trabecular bone loss for type 2 osteoporosis. Therefore, type 1 osteoporosis is caused by endogenous estrogen deficiency; type 2 osteoporosis is the result of the combined effect of the nutritional status of bone reconstruction efficiency, calcium and vitamin D, the influence of the intestine and kidney on mineral metabolism and the secretion level of parathyroid hormone. 2. Clinical manifestations Early on, there can be no discomfort, so it is called the “silent killer”. When the bone loss reaches 12%, symptoms start to appear. The most common symptoms in the middle and late stages are: pain, hunchback and short height, and fracture. The most common fracture sites are: hip, vertebrae, and distal radius, in that order. Diagnosis The diagnosis of osteoporosis is mainly based on medical history, bone density test, biochemical test, imaging test and bone biopsy. At present, the diagnostic criteria for white women recommended by WHo in 1994 are mostly used internationally, i.e., BMD-1.5SD to 2.5SD is considered osteoporosis. If the BMD is below -2.5SD with fracture, the diagnosis can be considered as established or severe osteoporosis. 4. Optimal assessment of osteoporosis and fracture The purpose of the patient’s assessment of osteoporosis risk is to diagnose osteoporosis on the basis of bone mass measurements and to determine the risk factors for fracture, i.e., to decide whether to receive treatment. History and physical examination are the basic methods of assessment, which should also include assessment of height and postural changes. Predictable populations with low bone mass include women, advanced age, estrogen deficiency, Caucasians, those with low body mass and low body mass index, family history of osteoporosis, smokers, and those with a history of fracture. Exercise, deep sensation, visual acuity, general physical condition, etc. and dietary beverages containing alcohol and caffeine can also have an effect on the reduction of bone mass. 5. Treatment (1) Nutrition Good nutrition is the basis for normal development. A balanced diet, adequate calories, and proper nutrition are the basis for the development of all tissues, including bone tissue. Adequate and appropriate exercise is important for everyone. The most important of these is to increase the intake of change. (2) Physical exercise Physical exercise is beneficial in increasing peak bone density, especially resistance and high-impact exercise. Exercise in older adults with adequate calcium and vitamin D intake can reduce the decline in BMD to some extent. (3) Basic pharmacological treatment Includes vitamin D and calcium. Adequate calcium and vitamin D intake is important to achieve high peak bone mass and to maintain bone mass throughout life. In patients with osteoporosis vitamin D deficiency is more important than calcium deficiency because oral calcium supplementation alone does not correct impaired calcium utilization in the absence of vitamin D. (4) Targeted drug therapy One is antiresorptive therapy, mainly based on counteracting the reabsorption effect in the dynamic balance of bone, including estrogen, selective estrogen receptor modulators, calcitonin and diphosphonates, etc.; one is anabolic therapy, mainly aimed at promoting bone formation, of which parathyroid hormone has more relevant studies and more positive effects, and fluoride can increase bone density, but the aspect of preventing fracture has been controversial. Androgen receptor modulators and posterior pituitary gland pressor substitutes have been rarely reported. In recent years, lipid-lowering drugs such as tadalafil have been found to be useful in the treatment of osteoporosis. (5) Surgical treatment, including percutaneous puncture cemented vertebroplasty or balloon kyphoplasty, has good efficacy in relieving the pain caused by vertebral compression fractures due to osteoporosis and preventing further fracture compression.