Osteopenia and osteoporosis are two disorders caracterized by bone density loss.
Osteoporosis remains asymptomatic until skeletal fragility is announced with a fracture. The clinical evidence of osteoporosis depends on which bones are involved. Thoracic and lumbar vertebral fractures are extremely common and produce loss of height and various deformities; including kyphoscoliosis that can compromise respiratory functions . Pulmonary embolism and pneumonia are common complications of fracture of the femoral neck, pelvis or spine. They cause as many as 50,000 deaths annually.
The following investigations are required for the diagnosis of osteoporosis.
The treatment plan in osteoporotic diseases is aimed at the prevention of bony fractures and improving lifestyle .
There are various options to treat osteoporotic conditions that are given below:
The following factors contribute to osteopenia in both men and women:
The endogenous risk factors include:
The exogenous risk factors include:
The incidence of osteoporotic lesions is 50% in women and 30% in men. In the United States, more than 10 million persons over age 50 are affected by osteoporosis and approximately 33.6 million people have osteopenia. The annual direct health care cost for osteoporotic lesions is $12 billion to $18 billion.
Bones naturally become thinner as people grow older. All people usually begin losing bone mass after the age of 30. In case of osteopenia, usually in middle age, existing bone cells are reabsorbed by the body faster than new bone is made. As this occurs, the bones lose minerals, becoming weaker with increased risk of fractures.
In osteoporosis, there is an increased bone resorption and reduced bone formation that results in reduced bone mineral density (BMD). In women after menopause, there is rapid reduction in bone mineral density as estrogen production is reduced. Estrogen affects indirectly cytokines and other growth factors in body. Estrogen deficiency thus leads to increased expression of RANKL that results to the recruitment of pro-osteoclasts as well as osteoclasts . In contrast, aging is associated with a decreased supply of osteoblasts in proportion to demand.
Calcium and Vitamin D deficiency on other hand, play an essential role in causing osteoporotic conditions. Reduced calcium levels lead to secondary hyperparathyroidism. Parathyroid hormone in turn increases calcium resorption from bones, making them brittle and porous. Other conditions that lead to bone loss include endocrinal disorders and drugs like glucocorticoids. Corticosteroids inhibit osteoblast function and enhance osteoblast apoptosis.
Osteopenia and osteoporosis are the most common metabolic bone disorders affecting over 200 million people worldwide .
Osteopenia refers to the condition in which the bone mineral density (BMD) is lower than the normal peak level.
Osteoporosis is a skeletal disorder characterized by bone mineral density even lower than that in osteopenia that results in the destruction and fracture of bones. Osteoporosis can be primary or secondary.
Osteopenia and osteoporosis are conditions in which the bones become thin and weak. The chances of fractures therefore, become significantly higher. The disease is more common in older age group and postmenopausal women. Usually there are no symptoms and the disease is detected after a fracture. With proper treatment, diet and lifestyle changes, the disease has a good prognosis.