Osteoporosis: bone Mass

Topics: Osteoporosis, Bone, Vitamin D Pages: 21 (7874 words) Published: November 16, 2008
Osteoporosis
Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in men, and may occur in anyone in the presence of particular hormonal disorders and other chronic diseases or as a result of medications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP). Given its influence on the risk of fragility fracture, osteoporosis may significantly affect life expectancy and quality of life. Osteoporosis can be prevented with lifestyle changes and sometimes medication; in people with osteoporosis, treatment may involve both. Lifestyle change includes preventing falls and exercise; medication includes calcium, vitamin D, bisphosphonates and several others. Fall-prevention advice includes exercise to tone deambulatory muscles, proprioception-improvement exercises; equilibrium therapies may be included. Exercise with its anabolic effect, may at the same time stop or reverse osteoporosis. Signs and symptoms

Osteoporosis itself has no specific symptoms; its main consequence is the increased risk of bone fractures. Osteoporotic fractures are those that occur in situations where healthy people would not normally break a bone; they are therefore regarded as fragility fractures. Typical fragility fractures occur in the vertebral column,. rib, hip and wrist.

Fractures

The symptoms of a vertebral collapse ("compression fracture") are sudden back pain, often with radiculopathic pain (shooting pain due to nerve compression) and rarely with spinal cord compression or cauda equina syndrome. Multiple vertebral fractures lead to a stooped posture, loss of height, and chronic pain with resultant reduction in mobility.[2] Fractures of the long bones acutely impair mobility and may require surgery. Hip fracture, in particular, usually requires prompt surgery, as there are serious risks associated with a hip fracture, such as deep vein thrombosis and a pulmonary embolism, and increased mortality.

[edit] Falls risk

The increased risk of falling associated with aging leads to fractures of the wrist, spine and hip. The risk of falling, in turn, is increased by impaired eyesight due to any cause (e.g. glaucoma, macular degeneration), balance disorder, movement disorders (e.g. Parkinson's disease), dementia, and sarcopenia (age-related loss of skeletal muscle). Collapse (transient loss of postural tone with or without loss of consciousness) leads to a significant risk of falls; causes of syncope are manifold but may include cardiac arrhythmias (irregular heart beat), vasovagal syncope, orthostatic hypotension (abnormal drop in blood pressure on standing up) and seizures. Removal of obstacles and loose carpets in the living environment may substantially reduce falls. Those with previous falls, as well as those with a gait or balance disorder, are most at risk Risk factors

Risk factors for osteoporotic fracture can be split between non-modifiable and (potentially) modifiable. In addition, there are specific diseases and disorders in which osteoporosis is a recognized complication. Medication use is theoretically modifiable, although in many cases the use of medication that increases osteoporosis risk is unavoidable.

[edit] Nonmodifiable

The most important risk factors for osteoporosis are advanced age (in both men and women) and female sex; estrogen deficiency following...

References: 1. ^ a b c WHO (1994). "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group". World Health Organization technical report series 843: 1–129. PMID 7941614. 
2
3. ^ Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ (2007). "Will my patient fall?". JAMA 297 (1): 77–86. doi:10.1001/jama.297.1.77. PMID 17200478. 
4
5. ^ a b c d e f Raisz L (2005). "Pathogenesis of osteoporosis: concepts, conflicts, and prospects.". J Clin Invest 115 (12): 3318–25. doi:10.1172/JCI27071. PMID 16322775, http://www.jci.org/cgi/content/full/115/12/3318. 
6
7. ^ a b Poole KE, Compston JE (December 2006). "Osteoporosis and its management". BMJ 333 (7581): 1251–6. doi:10.1136/bmj.39050.597350.47. PMID 17170416. 
8
9. ^ a b Nieves JW (2005). "Osteoporosis: the role of micronutrients.". Am J Clin Nutr 81 (5): 1232S–1239S. PMID 15883457, http://www.ajcn.org/cgi/content/full/81/5/1232S. 
10
11. ^ Wong PK, Christie JJ, Wark JD (2007). "The effects of smoking on bone health". Clin. Sci. 113 (5): 233–41. doi:10.1042/CS20060173. PMID 17663660, http://www.clinsci.org/cs/113/0233/cs1130233.htm. 
12
15. ^ "Soft drinks in schools". Pediatrics 113 (1 Pt 1): 152–4. 2004. PMID 14702469. 
16
17. ^ a b c d e f g h i j k l Kohlmeier, Lynn Kohlmeier (1998). "Osteoporosis - Risk Factors, Screening, and Treatment". Medscape Portals. Retrieved on 2008-05-11.
18. ^ a b c d Ebeling PR (2008). "Clinical practice. Osteoporosis in men". N Engl J Med 358 (14): 1474–82. doi:10.1056/NEJMcp0707217. PMID 18385499. 
19
20. ^ Gourlay M, Franceschini N, Sheyn Y (2007). "Prevention and treatment strategies for glucocorticoid-induced osteoporotic fractures". Clin Rheumatol 26 (2): 144–53. doi:10.1007/s10067-006-0315-1. PMID 16670825. 
21
22. ^ Ruiz-Irastorza G, Khamashta MA, Hughes GR (2002). "Heparin and osteoporosis during pregnancy: 2002 update". Lupus 11 (10): 680–2. doi:10.1191/0961203302lu262oa. PMID 12413068. 
23
24. ^ Yang YX, Lewis JD, Epstein S, Metz DC (2006). "Long-term proton pump inhibitor therapy and risk of hip fracture". JAMA 296: 2947–53. doi:10.1001/jama.296.24.2947. PMID 17190895. 
25
31. ^ Lyles KW, Colón-Emeric CS, Magaziner JS, et al (2007). "Zoledronic acid and clinical fractures and mortality after hip fracture". N Engl J Med 357: published online 2007–09–17. doi:10.1056/NEJMoa074941. PMID 17878149. 
32
33. ^ (September 2007) "6.6.2 Bisphosphonates", British National Formulary, 54, British Medical Association and Royal Pharmaceutical Society of Great Britain, p403. 
34
37. ^ Blake GM, Fogelman I (2007). "The correction of BMD measurements for bone strontium content". J Clin Densitom 10 (3): 259–65. doi:10.1016/j.jocd.2007.03.102. PMID 17543560. 
38
41. ^ "Nutrition and Bone Health". NIAMS (2005-11-01). Retrieved on 2008-01-28.
42. ^ "Calcium & Milk". Harvard School of Public Health (2007). Retrieved on 2008-01-28.
43. ^ Report of a Joint WHO/FAO/UNU Expert Consultation(2007) Protein and amino acid requirements in human nutrition, pp224-226. ISBN 978-92-4-120935-9
44
47. ^ Bolland MJ, Barber PA, Doughty RN, et al (2008). "Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial". BMJ 336: 262. doi:10.1136/bmj.39440.525752.BE. PMID 18198394. 
48
49. ^ Jackson RD, LaCroix AZ, Gass M, et al (2006). "Calcium plus vitamin D supplementation and the risk of fractures". N. Engl. J. Med. 354 (7): 669–83. doi:10.1056/NEJMoa055218. PMID 16481635. 
50
55. ^ Kerr D, Morton A, Dick I, Prince R (1996). "Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent". J. Bone Miner. Res. 11 (2): 218–25. PMID 8822346. 
56
59. ^ Hannan EL, Magaziner J, Wang JJ, et al (2001). "Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes". JAMA 285 (21): 2736–42. doi:10.1001/jama.285.21.2736. PMID 11386929. 
60
61. ^ a b Riggs, B.L.; Melton, Lj 3.r.d. (2005). "The worldwide problem of osteoporosis: insights afforded by epidemiology.". Bone. PMID 8573428. 
62
63. ^ Cauley JA, Hochberg MC, Lui LY et al (2007). "Long-term Risk of Incident Vertebral Fractures". JAMA 298: 2761–2767. doi:10.1001/jama.298.23.2761. PMID 18165669. 
64
65. ^ Feskanich D, Willett WC, Stampfer MJ, Colditz GA (1996). "Protein consumption and bone fractures in women". Am. J. Epidemiol. 143 (5): 472–9. PMID 8610662. 
66
67. ^ Lobstein JGCFM. Lehrbuch der pathologischen Anatomie. Stuttgart: Bd II, 1835.
68. ^ Albright F, Bloomberg E, Smith PH (1940). "Postmenopausal osteoporosis". Trans. Assoc. Am. Physicians. 55: 298–305. 
69
Continue Reading

Please join StudyMode to read the full document

You May Also Find These Documents Helpful

  • Osteoporosis and Bone Essay
  • osteoporosis Research Paper
  • Bone and Osteoporosis Essay
  • Osteoporosis Essay
  • Essay about Bone and Osteoporosis
  • Osteoporosis Essay
  • Bones: Bone Marrow Bone Essay
  • Essay about Osteoporosis

Become a StudyMode Member

Sign Up - It's Free