Osteoporosis  ("porous bone") is a characteristic pathology of the bone system, with a decrease in the current bone mass and mineralization quality and a change in structure. This increases the risk of bone fractures.

Osteoporosis is considered a "silent disease" because it is asymptomatic for a long time and is diagnosed only after the development of a fracture. Osteoporosis is the most common cause of spontaneous fractures in postmenopausal women and elderly men. Fractures can occur in any bone, but are more common in the femur, chest, and wrist.

Epidemiology

Globally, approximately 18,3% of the world's population suffers from osteoporosis. The disease is more common in women than in men.

After the age of 50, every second woman and every fourth man will experience a fracture at least once in their lifetime.

Symptoms of osteoporosis

In the early stages of the disease, the disease is usually asymptomatic. However, there are specific symptoms and complaints that indicate the diagnostics of osteoporosis, such as: pain in the lower back of the chest, change in body posture - with a tendency to lean forward, spontaneous bone fractures, difficulty breathing (reduced lung volume due to compression of the intervertebral discs), height reduction.

Osteoporosis causes, risk factors and complications

Bone tissue is very dynamic - constantly renewing and resorption (withdrawal) processes alternate. This process slows down with age, and most people reach their peak bone mass around age 30. As we age, the balance between the formation of new bone cells and the breakdown of bone cells is disturbed, and bone mass gradually decreases.

The two most important risk factors that affect the development of osteoporosis are: gender და Age.

The risk of developing osteoporosis increases with age, especially in postmenopausal women over the age of 50. Bone loss is most intense during the first 10 years after menopause, due to a decrease in the level of the female hormone estrogen.

Men over the age of 50 may also develop osteoporosis. According to statistics, osteoporosis is more common than prostate cancer in this age group of men.

Ethnicity – White and Asian women are more likely to develop osteoporosis than other female populations.

Bone structure and body mass - People with low height and weight have a higher risk of developing osteoporosis because their bone mass is much less.

family history – A family history of diseases such as spontaneous fractures under light stress increases the risk of developing osteoporosis.

Hormonal imbalance – These types of pathologies are accompanied by a tendency to decrease bone mass, so early screening is necessary. Thyroid, parathyroid and adrenal gland diseases, bariatric surgery and organ transplantation, hormone therapy for breast or prostate cancer, celiac disease, inflammatory bowel diseases, multiple myeloma and many other pathologies are often associated with hidden osteoporosis.

Medicines – Long-term use of some medications leads to a decrease in bone mass, which increases the risk of osteoporosis. These are: hormonal drugs, anti-cancer treatment, anti-epileptic drugs and others.

eating habits Significantly affects bone mineralization and mass. A diet poor in calcium and vitamin D eventually leads to bone loss and osteoporosis/osteopenia, as does tobacco and alcohol use.

from complications  Disabling fractures, especially in the vertebral and femur bones, are especially noteworthy, which worsen the quality of life and may even result in death.

Diagnosis of osteoporosis

Diagnosis of osteoporosis is usually based on routine screening tests. Such is osteodensitometry, which measures the degree and density of bone mineralization in specific areas - most commonly in the vertebrae and femur.

Screening research is recommended:

• In women over 65 years of age
• In the presence of risk factors for osteoporosis in women of any age.

Laboratory diagnostics

Laboratory tests are important to determine the degree of osteoporosis and to monitor the effect of treatment. Compared to densitometry, laboratory tests provide an answer to the effectiveness of treatment in a shorter period of time.

Bone tissue metabolism can be studied through the following laboratory tests:

N-telopeptide Urinary assessment of the degree of bone resorption in response to hormone therapy in postmenopausal women. The test is also used to evaluate the effectiveness of antiresorptive treatment in osteoporosis and Paget's disease.

Master - Bone alkaline phosphatase is a test to assess the effectiveness of anti-osteoporosis treatment.

osteocalcin – The study is informative for evaluating the effect of antiresorptive treatment and the risk of bone fracture.

Calcium და Vitamin D - These markers indirectly indicate the risk of fracture during treatment of osteoporosis.

Treatment of osteoporosis

The treatment plan for osteoporosis depends on the risk of pathological fractures in the next 10 years. Risk assessment is done with the data of both densitometric and laboratory diagnostic tests. If the risk of fracture is not very high, medical treatment may not be prescribed, and we limit ourselves only to the modification/change of those risk factors that contribute to the development of osteoporosis.

Osteoporosis treatment includes the administration of vitamins, nutritional supplements, minerals, and antiresorptive medications.

In the presence of a pathological fracture, it is necessary to start treatment, regardless of whether there are changes in the research data (sometimes the densitometric indicators are normal).

Vitamin D 

Rheumatoid arthritis 

For diagnostics and monitoring of osteoporosis, "Synevo" We offer:

Health care starts with accurate analyzes

Resources

https://www.eular.org/world-arthritis-day-general-information

n.manjaparashvili@synevo.ge