Osteoporosis

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Osteoporosis

NIH - Medical Encyclopedia Osteoporosis

"Osteoporosis occurs when the body fails to form enough new bone, or when too much old bone is reabsorbed by the body, or both. Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake is not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer. As people age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. Both situations can result in brittle, fragile bones that are subject to fractures, even without trauma. Usually, the loss occurs gradually over years. Many times, a person will sustain a fracture before becoming aware that the disease is present. By the time this occurs, the disease is in its advanced stages and the damage is severe. The leading causes are a drop in estrogen in women at the time of menopause, and a drop in testosterone in men. Women, especially those over the age of 50, get osteoporosis more often than men. Other causes include excess corticosteroid from Cushing's syndrome, hyperthyroidism (too much thyroid hormone), hyperparathyroidism, being confined to a bed, and bone cancers.

Symptoms occurring late in the disease include:

• Fractures of the vertebrae, wrists, or hips (usually the first indication) • Low back pain • Neck pain • Bone pain or tenderness • Loss of height over time • Stooped posture

EXERCISE

Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis. Studies show that exercises requiring muscles to pull on bones cause the bones to retain and perhaps even gain density. Researchers found that women who walk a mile a day have 4-7 more years of bone in reserve than women who don’t. Some of the recommended exercises include: • Weight-bearing exercises -- walking, jogging, playing tennis, dancing • Resistance exercises -- free weights, weight machines, stretch bands • Balancing exercises -- tai chi, yoga • Riding stationary bicycles • Using rowing machines • Walking • Jogging

DIET

A diet that includes an adequate amount of calcium, vitamin D, and protein should be maintained. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses for bone formation and maintenance is available. Supplemental calcium should be taken as needed to achieve recommended daily calcium dietary intake. Current recommendations are for nonpregnant, menstruating women to consume 1000 mg/day, pregnant women need 1200 mg/day, and postmenopausal or nursing mothers should consume 1500 mg/day. High-calcium foods include low-fat milk, yogurt, ice cream and cheese, tofu, salmon and sardines (with the bones), and leafy green vegetables, such as spinach and collard greens. Vitamin D aids in calcium absorption and 400-800 IU per day should be taken by all individuals with increased risk of calcium deficiency and osteoporosis. "

Highlighted Article

Osteoporosis: strategies for prevention and management. (Best Pract Res Clin Rheumatol. 2007)

"The goal of treatment is to reduce the risk of future fracture. Patients at high risk for fracture should be assessed and screened to exclude secondary causes for osteoporosis. Bisphosphonates (alendronate, etidronate, ibandronate, risedronate) are the first-line therapy for the majority of patients and these treatments can be given either orally or intravenously. Alternative treatment options include strontium ranelate and raloxifene. Anabolic therapy with parathyroid hormone can be considered for patients with severe disease. These patients will often require referral for specialist assessment and monitoring. All patients at risk of developing osteoporosis should be given lifestyle advice regarding dietary intake of calcium and vitamin D and regular weight-bearing exercise."

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Osteoporosis

General Information

NEWS:

High-trauma Fractures In Older Adults Linked To Osteoporosis, Increased Risk Of Another Fracture "Contrary to a widely held assumption, high-trauma nonspine fractures in older women and men, such as from a car crash, are associated with low bone mineral density and an increased risk of a subsequent fracture, according to a new study. These findings suggest that older adults who experience these fractures should be evaluated for osteoporosis."

Osteoporosis common in adults with hemophilia

Regular Exercise May Reduce Risk for Osteoporotic Fracture in Older Men

Spinal Fractures Affect One-Quarter of All Post-Menopausal Women "About one-quarter of all post-menopausal women suffer these breaks, typically caused by osteoporosis and simple movements such as bending or sneezing."

ARTICLES:

JOURNAL ARTICLES:

[Bone diseases with Pain. Osteoporosis.] (Clin Calcium. 2007) "Approximately 85 % of the patients with osteoporosis are suffered from bone pain."

Calcium and vitamin D intake influence bone mass, but not short-term fracture risk, in Caucasian postmenopausal women from the National Osteoporosis Risk Assessment (NORA) study. (Osteoporos Int. 2007) "CONCLUSIONS: Thus, higher calcium and vitamin D intakes significantly reduced the odds of osteoporosis but not the 3-year risk of fracture in these Caucasian women."

Diagnosis and treatment of osteoporosis in postmenopausal women with distal radius fracture in Germany. (Curr Med Res Opin. 2007) "CONCLUSIONS: A substantial proportion of postmenopausal women hospitalized with distal radius fracture were not sufficiently evaluated or treated for their potential risk of osteoporosis."

Diet and lifestyle associated with increased bone mineral density: cross-sectional study of Japanese elderly women at an osteoporosis outpatient clinic. (J Orthop Sci. 2007) "CONCLUSIONS: In this cross-sectional study at an osteoporosis outpatient clinic, patients with the habits of alcohol drinking, green tea drinking, and physical activity had significantly higher BMD, and those who smoked had significantly lower BMD than patients without each habit after adjusting for age, BMI, and other variables regarding lifestyle."

Effects of meat consumption and vegetarian diet on risk of wrist fracture over 25 years in a cohort of peri- and postmenopausal women. (Public Health Nutr. 2007)

High prevalence of osteoporosis in Saudi men. (Saudi Med J. 2007) "CONCLUSION: Low bone mineral density occurs with high frequency in Saudi men. Lumbar spine appears to be affected to a higher degree. The reason for the high prevalence of osteoporosis in Saudi men is unclear. Possible underlying causes include nutritional, life style and genetic factors."

Improving Care of Patients At-Risk for Osteoporosis: A Randomized Controlled Trial. (J Gen Intern Med. 2007)

Long-term Risk of Incident Vertebral Fractures. (JAMA. 2007) “CONCLUSIONS: Low BMD and prevalent vertebral fractures are independently related to new vertebral fractures over 15 years of follow-up. Women with a prevalent vertebral fracture have a substantially increased absolute risk of an incident fracture, especially if they have osteoporosis diagnosed by BMD.”

Male Osteoporosis with Vertebral Fractures? Look for Ankylosing Spondylitis! A Report of 10 Cases. (J Rheumatol. 2007)

Male osteoporosis: deadly, but ignored. (Am J Med Sci. 2007)

Mild prevalent and incident vertebral fractures are risk factors for new fractures. (Osteoporos Int. 2007) "CONCLUSION: Mild vertebral fractures are a risk factor for subsequent vertebral and non-vertebral fracture in postmenopausal women with osteoporosis; 1 out of 4 patients with an incident mild vertebral fracture in 2 years will fracture again within the 2 next years."

Patients with osteoporosis on steroid medication tend to sustain subsequent fractures. ( Am J Neuroradiol. 2007)

Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass. (J Bone Miner Metab. 2007)

Risk of Subsequent Fracture After Low-Trauma Fracture in Men and Women (JAMA. 2007) "Conclusion After an initial low-trauma fracture, absolute risk of subsequent fracture was similar for men and women. This increased risk occurred for virtually all clinical fractures and persisted for up to 10 years."

The diagnosis and treatment of male osteoporosis: Defining, assessing, and preventing skeletal fragility in men. (Eur J Intern Med. 2007) "In men with osteoporosis, it remains particularly critical to exclude underlying pathological causes as these are much more likely to be present than in women."

Thyroid status during skeletal development determines adult bone structure and mineralization. (Mol Endocrinol. 2007)

Trabecular bone microarchitecture is related to the number of risk factors and etiology in osteoporotic men. (Microsc Res Tech. 2007)

[Vertebral fractures, osteoporosis and vitamin D levels in Chilean postmenopausal women.] (Rev Med Chil. 2007) "Conclusions: Thirty percent of postmenopausal women in this series had a vertebral fractures. Osteoporosis and vitamin D deficiency were also common. Most vertebral fractures were observed in women without osteoporosis by densitometric criteria."

Vitamin D status: effects on quality of life in osteoporosis among Turkish women. (Qual Life Res. 2007) "CONCLUSIONS: Vitamin D insufficiency affects physical, social and mental functions of osteoporosis patients and impairs QOL. Vitamin D was found to be one of the factors affecting QOL."

Wrist fracture as a predictor of future fractures in younger versus older postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). (Osteoporos Int. 2007)

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