Osteoporosis: symptoms, treatment, prevention, causes
What is it? - Osteoporosis is a metabolic disorder that is characterized by a decrease in bone mineral density.
This process exceeds the age and sex standards, which is accompanied by the development of a number of complications, in the first place it is a question of fractures.
The disease was first isolated in a separate nosological unit in 1925.However, the changes inherent in this pathology, were found even during the excavation of ancient civilizations.
Previously, the disease was not differentiated from osteomalacia, other bone disorders, etc., which led to various problems in the treatment process. The final isolation of osteoporosis from similar diseases occurred in 1984.It was from this period that an active study of this pathological process began, which allowed achieving good therapeutic results.
The prevalence of osteoporosis has been growing steadily lately, as has the frequency of fractures that are the consequence of the main process. Thus, according to WHO statistics, this disease ranks 4th in the overall structure of all human pathological processes( the first three pathologies are heart and vascular diseases, oncological diseases, diabetes mellitus).
The causes of osteoporosis are multifactorial. The maximum impact on them will reduce the likelihood of developing this disease, especially in elderly patients. So, the main causative factors are:
There are no symptoms of osteoporosis for a long time. In many patients, the first signs of the disease are fractures of the bones, which quite easily arise. However, before their appearance, patients note the presence of pain syndrome of different localization. Most often it's the spine and lower limbs.
All these changes cause a decrease in the motor activity of a person. In addition, they adversely affect the quality of life of the patient, limiting its performance.
Early diagnosis of osteoporosis is an important area that can prevent the development of complications of the disease. To this end, to focus on clinical symptoms is not rational. Therefore, the use of additional methods of investigation is shown.
The most informative of them are:
Treatment of the disease has the following objectives:
The greatest danger is a fracture of the neck of the hip. This is due to the following circumstances:
Osteoporosis is the main cause of fractures. They can affect any bone. However, most often fractures of a certain localization are found:
Prevention of osteoporosis is unthinkable without knowledge of factors that increase bone resistance and increase bone mass. These factors include:
In addition, there are certain protective factors that contribute to the increase in bone mineral density. However, great importance is attached to early preclinical diagnosis using modern research methods.
This will allow starting pharmacological correction at the earliest stages of the disease, which will prevent the development of fractures.
This process exceeds the age and sex standards, which is accompanied by the development of a number of complications, in the first place it is a question of fractures.
The disease was first isolated in a separate nosological unit in 1925.However, the changes inherent in this pathology, were found even during the excavation of ancient civilizations.
Previously, the disease was not differentiated from osteomalacia, other bone disorders, etc., which led to various problems in the treatment process. The final isolation of osteoporosis from similar diseases occurred in 1984.It was from this period that an active study of this pathological process began, which allowed achieving good therapeutic results.
The prevalence of osteoporosis has been growing steadily lately, as has the frequency of fractures that are the consequence of the main process. Thus, according to WHO statistics, this disease ranks 4th in the overall structure of all human pathological processes( the first three pathologies are heart and vascular diseases, oncological diseases, diabetes mellitus).
Causes of Osteoporosis and Risk Factors
The causes of osteoporosis are multifactorial. The maximum impact on them will reduce the likelihood of developing this disease, especially in elderly patients. So, the main causative factors are:
- 1) Dietary nutrition for weight loss, which is characterized by a reduced content of dietary phosphorus, calcium and fat( they are necessary for the assimilation of vitamin D, which is fat-soluble).Fish and cereals, which are often used in the diet, also contribute to the development of this disease through developing acidosis. And he, in turn, stimulates the production of parathyroid hormone, which mobilizes calcium from the bones. A similar situation develops and if a person eats a lot of protein-containing food. Dairy products and eggs, on the contrary, help to improve the condition of bones, increasing their mineral density.
- 2) Age changes, which are caused by a decrease in arterial nutrition of bone tissue, and also directly by the aging process. In women, an additional factor is the reduction in the level of estrogen in menopausal age, since these hormones contribute to an increase in bone mineral density.
- 3) Conditions that increase the body's need for calcium. These include pregnancy, the period of breastfeeding, chronic diseases that deplete the body and contribute to the consumption of calcium.
- 4) Weighed down by this disease heredity. At present, there is evidence of the existence of one gene, which is responsible for the development of osteoporosis in the immediate family. They have this disease develops a few years earlier than in the population.
- 5) Stressful situations, especially chronic. Against this background, the synthesis of corticosteroids in the body increases, which promote the elution of calcium from bones and reduce their strength.
- 6) Use of corticosteroids in large doses for therapeutic purposes. This reason for osteoporosis became relevant from the middle of the 20th century, when the active use of these drugs began.
- 7) Hypodinamia
- 8) Smoking and alcoholism
- 9) A number of concomitant diseases - diabetes mellitus, rheumatoid arthritis, liver cirrhosis, leukemia, vibration disease, etc.
- 10) Deficiency in the body of some trace elements that participate in the exchange of calcium( manganese,magnesium, iron, copper and others)
- 11) Diseases of the endocrine glands, accompanied by increased activity of parathyroid glands, thyroid, adrenal glands and decreased gonadal activity.
Symptoms of osteoporosis
There are no symptoms of osteoporosis for a long time. In many patients, the first signs of the disease are fractures of the bones, which quite easily arise. However, before their appearance, patients note the presence of pain syndrome of different localization. Most often it's the spine and lower limbs.
All these changes cause a decrease in the motor activity of a person. In addition, they adversely affect the quality of life of the patient, limiting its performance.
Diagnosis of Osteoporosis
Early diagnosis of osteoporosis is an important area that can prevent the development of complications of the disease. To this end, to focus on clinical symptoms is not rational. Therefore, the use of additional methods of investigation is shown.
The most informative of them are:
- densitometry, determining bone mineral density
- X-ray adsorptiometry
- Evaluation of urinary excretion of calcium and hydroxyproline in the urine that increase with osteoporosis
- Assessment of osteocalcin level per day
- Assessment of alkaline phosphatase level specific for bone tissue
- DefinitionEstradiol and testosterone in women and men respectively.
Treatment of osteoporosis
Treatment of the disease has the following objectives:
- 1) Reduce the activity of bone destruction processes, as modern drugs do not yet allow increasing bone mineral density
- 2) Prevent fractures.
- 1) The use of calcium and vitamin D, which allows you to maintain the necessary level of calcium in the blood, which is needed for normal bone tissue synthesis. In addition, drugs that reduce the level of bone resorption, contribute to a decrease in calcium in the body, closing the vicious circle. However, restricting treatment to calcium and vitamin D alone is not rational, since there is no direct proportion to their increase in bone as compared to the blood content.
- 2) Calcitonin( Mikaltsik) and bisphosphonates, which reduce the activity of decomposition processes in bone tissue. Improvement of the bisphosphonate group led to the creation of three generations of these drugs, the latter of which has a minimal amount of side effects.
Forecast
The greatest danger is a fracture of the neck of the hip. This is due to the following circumstances:
- lethality( death) accompanies 20% of the fractures of this localization
- 50% of patients subsequently remain disabled, requiring very expensive treatment.
- increases the likelihood of pneumonia - pneumonia - due to prolonged immobilization( immobility).
Osteoporosis Complications
Osteoporosis is the main cause of fractures. They can affect any bone. However, most often fractures of a certain localization are found:
- proximal femur( femoral neck, head, upper third of the body)
- of the vertebral body
- distal parts of the forearm bones( for example, fracture of the radius in a typical place).
Prevention of osteoporosis
Prevention of osteoporosis is unthinkable without knowledge of factors that increase bone resistance and increase bone mass. These factors include:
- regular consumption of dairy products and eggs
- intake of vitamin D
- an adequate level of safe ultraviolet radiation, which increases the synthesis of vitamin D
- in the body of sufficient physical activity, including regular exercise.
In addition, there are certain protective factors that contribute to the increase in bone mineral density. However, great importance is attached to early preclinical diagnosis using modern research methods.
This will allow starting pharmacological correction at the earliest stages of the disease, which will prevent the development of fractures.