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                                                                   Osteoporosis

                                                             Andrew Ying-Siu Lee, MD,PhD.

 

       Osteoporosis means low bone mass and microarchitectual deterioration of bone tissue leading to bone

fragility and susceptibility to fracture.  It commonly affects vertebral, hip and wrist bones.  The most devastating

hip fracture causes 5-20% mortality within 1 year and >50% incapacitated.  Other symptoms include: chronic

back pain, humpbacked, difficulty in breathing etc.

 

       Risk factors of osteoporosis include: Age, low BMD, female gender, history of fragility fracture,

history of parental hip fracture, low body weight, severe immobility, lifestyle (smoking, alcohol),

diseases (rheumatoid arthritis, osteoarthritis, endocrine disease, chronic obstructive pulmonary

disease, diabetes mellitus, chronic renal failure etc.).

 

       Dignosis of osteoporosis is usually measurement of bone mineral density BMD (T score) by

dual X-ray absorptiometry, as below:-

 

Classification of osteoporosis

nNormal                               bone mineral density (BMD) not more than 1 standard deviation (SD)

                                              below young normal adult mean (T score > -1)

 

nOsteopenia                       BMD 1 2.5 SD below (T score -1 to 2.5)

  (low bone mass)

nOsteoporosis                    BMD > 2.5 SD below (T score < - 2.5)

nSevere  osteoporosis      osteoporosis with fragility fracture

 

       Therapy of osteoporosis include: exercise, calcium and vitamin D supplementation, nasal spray

calcitonin (inhibit osteolysis), biphosphonates (inhibit osteolysis) and parathyroid hormone (activate

bone cell activity and increase bone density).