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October 20 has been designated as World Osteoporosis Day, with the aim of raising awareness of the disease.
In developed countries, osteoporosis is found in 25-35% of women and 15-20% of men aged 50 years and older. It is noteworthy that a recent Greek study (by the Hellenic Foundation for Rheumatological Research) found:
- 28.4% of Greek women aged 50 and over suffer from osteoporosis
- 75% of those affected are unaware of it
This fact highlights the need to educate and systematically inform the public about early diagnosis and the implementation of preventive measures.
A few words about the bones
Bone is a living and active tissue that is constantly renewed. Old bone tissue is broken down by cells called osteoclasts and replaced by new bone mineral elements, by cells called osteoblasts.
We all experience a loss of bone density, to some degree, as we age. The term "osteoporosis" is used when bones begin to lose their elasticity and become brittle.
What is osteoporosis?
Osteoporosis is a chronic disease of bone metabolism, in which there is a gradual decrease in bone density and quality. As a result, bones - over time - become thinner, more fragile and the risk of fracture increases. The condition affects a significant proportion of the population, most commonly women after the menopause.
In osteoporosis, essentially, there is an imbalance in the activity between osteoclasts and osteoblasts, hence in the balance between the breakdown of old bone and the creation of new bone. This imbalance gradually leads to the weakening of bone.
Osteoporosis is divided into two categories:
- Primary - Divided into two subcategories:
- Postmenopausal osteoporosis
- Osteoporosis of the elderly
- Secondary - Due to certain conditions or use of certain medications over a long period of time.
Who is most at risk?
The most common form of osteoporosis is postmenopausal. It occurs in post-menopausal women and is associated with reduced estrogen production. Osteoporosis in the elderly is also common, occurring in people over 70 years of age.
What are the risk factors?
Risk factors that have been associated with osteoporosis are:
- Family history
- History of previous fractures
- Height and weight of the person
- Hormonal disorders (early menopause or amenorrhea)
- Thyroid disorders
- Low calcium intake
- Eating disorders
- Smoking
- Lack of exercise
- Excessive alcohol consumption
- Pre-existing conditions (hyperparathyroidism, cancer, rheumatoid arthritis, malabsorption syndrome, etc.)
- Certain medications (cortisone, chemotherapy, etc.)
What are the symptoms?
Osteoporosis has been described as a "silent disease", as it does not manifest itself with any symptoms. The patient usually reaches the doctor when the disease is in an advanced stage and has already caused the first fracture.
Osteoporosis causes low-energy fractures, i.e. fractures resulting from simple everyday movements. These occur most commonly in the spine, wrist and hip.
In addition, as the bones undergo changes, symptoms such as back pain, kyphosis, scoliosis and loss of height can occur.
How is the diagnosis made?
Osteoporosis is diagnosed by measuring bone density.
Bone mineral density (BMD), as measured by dual-energy X-ray absorptiometry (DEXA), is the established method for diagnosing osteoporosis and monitoring osteoporotic patients. The severity of osteoporosis is assessed by the statistical benchmark T-SCORE.
There are certain cases in which systematic measurement of bone density is necessary. These are:
- Women immediately after menopause
- People taking cortisone for a long time
- Women with family history
- People over 70 years old
What is the treatment?
The treatment of osteoporosis aims to increase bone mass and inhibit further bone loss, with the ultimate goal of avoiding fractures.
Medication should be given by the treating physician, as it is individualized for each patient. If the risk of fracture is not high, then treatment starts with simple changes in the patient's daily habits (diet, activities). In cases of people who are at a high enough risk of fracture, the doctor prescribes medication.
The drugs used to treat osteoporosis increase bone production and/or inhibit bone resorption. These are:
- Bisphosphonates
- Strontium
- Selective estrogen receptor modifiers
- Teriparatidis
- Parathormone
- Denosumabi
- Estrogen
- Calcium
- Vitamin D
Is there any prevention?
There are some preventive measures that can prevent or halt the progression of the condition. These are:
- Daily intake of vitamin D and calcium through food
- Physical exercise
- Hormonal regulation in cases of early menopause
- Maintaining normal body weight
- Stop smoking
- Stop excessive drinking
- Preventive administration of vitamin D and/or antiosteoporotic drugs in case of cortisone intake
- Correction of conditions that predispose to osteoporosis
References
https://osteon.gr/conditions/osteoporosi/
https://www.hygeia.gr/services/department/reymatologia/osteoporosi/
https://affidea.gr/news/osteoporosi-ola-osa-prepei-na-gnorizoume/
https://www.athensorthocenter.gr/οστεοπορωση
https://www.iatriko.gr/el/disease/osteoporosi-osteopenia?cl=609
http://www.elire.gr/info_det.php?di=21
https://anastasopoulosstefanos.gr/τι-ειναι-η-οστεοπορωση/
https://spine-scoliosis.gr/osteoporosi/
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