Osteoporosis is a disease in which bones become fragile and more likely to break.Bone mineral density (BMD) reflects the balance between bone resorption and formation.Peak BMD is reached from age 20-35 for men and women.Osteoporosis occurs when resorption exceeds formation ,which resultant bone loss.It is diagnosed based on T-score,with the gold standard measurement being dual energy x-ray absorpimometry (DXA)of the hip and spine BMD.A T-score is the number of standard deviations away from the mean BMD for the young normal population.
Annually osteoporosis is responsible for 1.5 million fractures, typically in the hip, spine, and wrist.Osteoporosis can be classified as post menopausal,age related or secondary.Postmenopausalwoman who present with fractures should be evaluated by BMD testing to confirm the diagnosis and determine the disease severity.
PREVENTION OF OSTEOPOROSIS
• Dietary approaches- adequate intake of calcium and vitamin D are important for the prevention of bone loss.Dietary sources of vitamin D include fatty fish,dairy products, and liver.Caffeine has been inconsistently associated with decreased bone mass.Other possible dietary factors that influence risk for fractures include viatmin K intake, low protein intake, anf excessive vitamin A intake.
Lifestyle Modifications
• It is recommended to avoid tobacco.Smoking increases ones hip fracture and is associated with decreasing BMD
• Moderation of alcohol is recommended.
• Physical activity for patients with osteoporosis should be encouraged.Regular exercise and high impact activities,contributes to the development of high peak bone mass and may reduce the risk of falls in older individuals.
Pharmacologic Interventions for Prevention and Treatment
• The National Osteoporosis Foundation suggests initiating therapy to reduce fracture risk.
• The U.S food and drug administration has approved hormone replacement therapy,