Osteoporosis: Know About The Disease That Makes The Bone Fragile
Osteoporosis is a medical condition in which the mineral density of the bone is below the mean peak bone mass by 2.5 standard deviations or more when considered the average value of young, healthy adults. This is as measured by dual-energy X-ray absorptiometery.
When the bones get affected making them weak and fragile, as a result increasing the risk to break (fracture) then it indicates that there is a presence of a fragility fracture. This is explained by the term “established osteoporosis”
Common form of osteoporosis:
1) Primary Osteoporosis:
Type I: This type of osteoporosis is also known as postmenopausal osteoporosis.
Type II: Also called as senile osteoporosis, it typically occurs after the age 75 years and can affect both females and males at a ratio of 2:1
2) Secondary Osteoporosis:
This type of osteoporosis can affect people of all ages and of any gender. This medical condition develops from chronic predisposing medical problems or disease. Another cause is due to the use of medications such as glucocorticoids for long periods of time. The term used in this case is steroid induced or glucocorticoid-induced osteoporosis.
It can take several years to develop this condition. Even a minor accident or a fall can have an impact to fracture the bone. The typical areas in the body where fragility fractures might occur are in the vertebral column, rib, hip and wrist.
- Joint pain
- Loss of height and stooped posture.
- A curved upper back (dowager’s hump).
There are several risk factors that contribute to development of osteoporosis. Decrease in the density of bones can lead to this condition too.
Osteoporosis can affect both the genders, although women are at a higher risk of developing it than men. This happens as the bone density is affected by the change in hormone levels. For healthy bones in women, estrogen, the female hormone is essential. There is a decrease in the levels of oestrogen in the female body post menopause which results in the decrease of bone density.
The exact cause of developing osteoporosis is unknown. But as in the case for women, even for men it is found that for healthy bones, testosterone, the male hormone helps keeping the bones healthy. The advantage is that the male body continues to produce testosterone even in old age. Although it should be remembered that with low levels of testosterone the risk of osteoporosis increases.
Another cause that increases the risk for developing osteoporosis are the hormone-related diseases :
- Hyperthyroidism (overactive thyroid gland)
- Disorders of the adrenal glands, such as Cushing’s syndrome
- Reduced amounts of sex hormones (oestrogen and testosterone)
- Disorders of the pituitary gland
- Hyperparathyroidism (overactivity of the parathyroid glands).
Other factors that can lead to a higher risk of developing osteoporosis and broken bones are:
- Family history of osteoporosis
- BMI equal to or lesser than 19
- Usage of high-dose corticosteroid treatment which is widely used for medical conditions such as arthritis and asthma
- Heavy drinking and smoking
- Rheumatoid arthritis
The diagnosis is done when the bones get weak and fractured. It can happen that a patient visits the doctor for some other bone related issue and/or an x-ray is conducted for the same or other reason, and the bones in the x-ray show up to be weak.
- Conventional Radiography
To detect the complications of osteopenia, which is reduced bone mass pre-osteoporosis, the conventional radiography is either done solely or along with CT scan (Computed Tomography) and MRI (Magnetic Resonance Imaging). Although for the X-ray to be clear and to show correct images certain amount of bone loss which is about 30%, is required as radiography is insensitive to detect the disease at an early stage. Cortical thinning and increased radiolucency are the main radiographic features of generalized osteoporosis. Dowager’s Hump is a term given to the kyphosis of the thoracic spine which is developed due to the involvement of multiple vertebral bodies
- Dual-energy X-Ray
The gold standard in the diagnosis is the DXA or Dual-energy X-ray absorptiometry.
To detect the bone degradation, a very useful tool are chemical biomarkers. An important constituent in bones is Type-1 collagen protein which is broken down by the enzyme cathespin K. The antibodies will recognise neoepitope which is the resulting fragment which helps in the diagnosis. Another fragment of the breakdown of the type-1 collagen is C-telopeptides which is excreted by the body by the way of urination can also be used as a biomarker for osteoporosis.
Chances to develop osteoporosis is increased manifold because of tobacco smoking and high alcohol intake.
Fractures can be prevented when Vitamin D and calcium supplements are taken, although there are certain side effects associated in taking these supplements in excessive amounts. Risk of having myocardial infractions and kidney stones are two of the known side effects.
To prevent and decrease the risk of future fractures bisphosphonates are considered to be useful. An effective treatment tool for postmenopausal osteoporosis in women is Teriparatide which is a recombinant parathyroid hormone.
Physical activity play a very important role in preventing to develop this medical condition. Maintaining a regular exercise regime is necessary. Walking or jogging for at least 30 minutes every day and 5 days in a week with some amount of weight lifting is beneficial. Another important lifestyle habit is to keep a healthy diet with all vitamins, minerals and nutrients consumed in a balanced way. To have healthy bones, calcium and vitamin D are quite essential.
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