Osteoporosis

A full cycle of bone remodeling takes about two to three months. We reach the peak bone mass in your mid-30s. While menopause, bone loss in women increases dramatically. The more bone you have in the bank the less likely to develop osteoporosis. Osteoporosis is a skeletal disorder characterized by impaired bone strength that increases the risk of fracture, beside it is an international health problem that will only increase in scope and severity as the population ages.

In the United States alone, osteoporosis affects >10 million individuals aged >50 years, an additional 33.6 million have low bone mass and are potentially at risk for osteoporosis and its compilation. Patients with or at risk of osteoporosis are most likely to have a history of low intake of calcium and vitamin D. Although it is often thought of as a women disease, osteoporosis increase from 19% among women aged 65 to 74 years to >50%in women aged >85 years. The number of people aged >50 years with osteoporosis is expected to increase to 12 million by 2010 and to nearly 14 million to 2020. Cost related to osteoporosis in 2002 direct care expenditures for osteoporosis fractures ranged from $12 billion to $18 billion. Hip and vertebral fractures are most important types of fracture. Hip fractures are associated with substantially increased risk of institutionalization and death. Vertebral fractures are associated with chronic back pain, spinal deformity.

Diet appears is linked to osteoporosis, and calcium and vitamin D are both important. Vitamin D and calcium supplementation have shown positive effects on femoral bone mineral density on the contrary. Preventing bone loss associated with menopause and aging and maintaining bone mineral content provide important opportunities for the prevention of osteoporosis and fracture.

Calcium is the most abundant mineral in the body and makes up 1.9% of the body by weight and 99% in the skeleton. Calcium plays an important role in human health as a vital part of bones and teeth, is an essential mineral to skeletal health because it attain and maintain bones size, bone mass and bone architecture. Extracellular calcium is also an essential cofactor in clotting factors and adhesions molecules and is essential for the proper formation of bone. The development and maintenance of bone mass require a sufficient daily calcium intake to offset daily calcium losses, support bone gain and ultimately prevent fractures. Calcium has vital function and involve physiological and biochemical processes that are critical for life such as muscle contraction, nerve transmission, maintenance of blood vessel secretions.

SCREENING AND DIAGNOSIS
Measurement of bone mass is used to determine severity of bone loss and fracture risk and to distinguish patience with osteoporosis from those with osteopenia and normal bone density. The best screening test is dual energy X-ray absorptiometry (DEXA).
 

RISK FACTORS FOR OSTEOPOROSIS FRACTURES IN WOMEN 
a) Age
b) Premature menopause
c) Primary amenorrhea or associated with low estrogen
d) Asian and white ethnic origin
e) Low bone density
f) High bone turnover
g) Family history
h) Low body weight
i) Cigarette smoking
j) Neuromuscular disorders
k) Excessive alcohol consumption
l) dietary calcium intake
m) Vitamin D deficiency

World Health Organization definition of osteoporosis operational definitions for osteoporosis and osteopenia are shown below

Reference:
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