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The silent "killer" Osteoporosis

Saturday, April 25, 2020

Osteoporosis  patients should go to the endocrinologist

  This is a kind of disease, which is a mystery that disappears and appears, because its onset is carried out unknowingly, but its consequences are very serious, so it is called " silent killer " . The disease is osteoporosis. When it comes to osteoporosis, most people think that it seems that it is possible for people to get the disease only when they reach old age. However, recent studies have shown that osteoporosis is breaking the " age " record and developing towards younger age. According to expert estimates, the number of osteoporosis patients over the age of 40 has reached 112 million nationwide , and the number of potential patients with reduced bone density is greater. The total number of patients exceeds hypertension and diabetes, ranking first in the incidence of chronic diseases in China. The treatment and prevention of osteoporosis is essential. Therefore, today's Health Channel "Doctor of Medicine" invited Dr. Zhao Wenhui from the Department of Endocrinology, Tsinghua Chang Gung Hospital, Beijing to answer questions about osteoporosis .
"Osteoporosis" may be heard more by everyone. Its accurate definition is a disease of the skeletal system that is prone to fracture due to decreased bone strength. Osteoporosis is characterized by decreased bone density and bone strength, and the consequence of osteoporosis is fracture.

Many patients say that this is a disease of the skeletal system, and we are going to see an orthopedist. Actually, we use diabetes as an analogy. Patients with diabetes control blood glucose in the endocrinology department when no complications occur. If he is blind, has retinopathy, and has bleeding, he should go to the ophthalmologist. This is also the case of osteoporosis in fractures. When a fracture occurs, it must be seen in orthopedics. Before the fracture, the osteoporosis stage must be treated by the endocrinologist. If this osteoporosis is not well controlled, a fracture occurs, the fracture is treated in orthopedics, stabilized, and the bones grow. In the future, if no more fractures occur, anti-osteoporosis treatment will continue Performed in the endocrinology department.

How to know if I have osteoporosis?

   Osteoporosis is also known as the "silent killer". It can be known from this name that its symptoms are not typical. Many people have discovered fractures before they know that they have osteoporosis.

 First, if you have risk factors for osteoporosis, you may need to check for osteoporosis earlier. What are the factors prone to osteoporosis? It is roughly divided into two categories, one is called inherent factors, that is, immutable factors. For example, older people may be more prone to osteoporosis; after menopause, women without estrogen are prone to osteoporosis; if you have a family history of bone fractures, you may be more prone to osteoporosis.

 There are also some external factors, including some bad habits, or the combination of other diseases. Bad habits include smoking, drinking, drinking strong tea, or lack of exercise. They eat very little calcium, eat particularly salty, high-sodium diets, and are very susceptible to osteoporosis.
How do I test for osteoporosis?

  There is a simple one-minute questionnaire called osteoporosis. This questionnaire includes a total of 10 questions. If you answer "yes" to any of these questions, you may be more likely to get osteoporosis. For this one-minute questionnaire, I can pick two simple questions.

  One of the questions is, does your height decrease from your highest height in your youth? If you drop more than 3 cm, you may have osteoporosis. Why is the decrease in height a sign of osteoporosis? It is because of osteoporosis, especially of the thora columbar vertebra, it is easy to cause compressive fractures, the cone is flattened, and the height becomes shorter. Moreover, the flattening of the cone is often a new type of squashing. It turned out to be a square cone, which later became narrow in front and wide in the back. People will appear not only shorter but also bent over humpback. This is a sign of osteoporosis that is relatively easy to see in life.

  For example, if you drink heavily or smoke more than 20 cigarettes a day, such people are more likely to have osteoporosis. If you have had a fragile fracture, you must have osteoporosis. A “fragile fracture” is a fracture that occurs in a very light condition compared to a traumatic fracture. For example, if we sit on a stool and fall to the ground without sitting firmly, most people will not fracture. If a fracture occurs under such a light external force, it is called a “fragile fracture”, and it is likely that such a fragile fracture has already occurred when osteoporosis has already occurred.

  So we will simply remember three, one is a change in height, one is a bad lifestyle, and the other is whether there are fragile fractures.

Changes in bones before and after osteoporosis

If we look at it with naked eyes, we can see that there are only two differences between the two. The bone is divided into cortical bone and cancellous bone. Cortical bone is the thicker layer on the outside, and cancellous bone has many trabeculae inside. In normal human bones, the trabeculae in the cancellous bone are very dense, and each of the trabeculae is very thick. Each of its trabeculae is horizontal and vertical, criss-cross, and has a relatively large supporting force. .

In patients with osteoporosis, the cortical bone is thinner, the trabeculae of cancellous bone are very sparse, each trabecular bone is very thin and fragile, and the horizontal and vertical grids are sparse, so the support force becomes difference.

This picture can be seen. Our bones are like this table. The table on the far right has a more complete structure. There are table legs, and the table scale is thicker. For patients with osteoporosis, the table scale may become thinner. , Not strong, if it is more serious, the table legs will not be so strong. For relatively strong bones, a lot of books will not collapse, and for loose bones, a few light books may collapse and fracture.

Not all old people have osteoporosis

    First of all, the elderly are more likely to suffer from osteoporosis , but conversely, is osteoporosis only the elderly? This sentence can not give an accurate answer, not the elderly will also have osteoporosis.
First, menopausal women before the age of 45 are at high risk for osteoporosis. Women are prone to osteoporosis because women are menopausal and lack the protection of estrogen. In addition, she is thin, has less muscle, and has less stress on the bones.

Second, people with a family history of fractures are at high risk.

Third, they are thinner and have less exercise. These people are at high risk. Because muscles are attached to your bones, when you exercise, the pulling of bones is a process that promotes the formation of bones. A thin person has less muscle in the relative bones, so its pulling force is less. So many of the osteoporosis patients we see are thin old ladies.

Finally, there are some endocrine diseases, such as thyroid disease, parathyroid disease, these diseases are prone to osteoporosis.

Tea drinking interferes with calcium intake in the gastrointestinal tract and can easily cause osteoporosis

    Drinking tea or coffee is the main cause of the increased risk of osteoporosis because it interferes with the intake and absorption of calcium in the gastrointestinal tract.

Our bones are equivalent to a calcium reservoir, which can also be compared to a calcium bank. Before the age of 40 is a process in which we continuously deposit money in banks. In other words, before the age of 40 , the calcium stores in our bones continued to increase. After the age of 40 , this no longer increased, and reached the peak and valley volume. After the age of 40 , calcium begins to lose. The faster it is lost, the faster your osteoporosis progresses.

The first is female estrogen deficiency. After women enter menopause, calcium is lost very quickly. Second, those bad factors, such as the strong tea you just asked, affect the calcium intake. Originally, you began to lose calcium, and your intake decreased, and his osteoporosis progressed quickly. There are also some diseases. For example, some rheumatic diseases may require glucocorticoids, which may also increase the incidence of osteoporosis.

Vertebral fractures are prone to respiratory diseases

The main purpose of osteoporosis treatment is to prevent fractures. One of the most common locations for fractures is a pyramidal fracture. As you can imagine, after the fracture of the pyramid, the height has become shorter, the back has become curved, and the shape is not good-looking. This may be only a minor aspect. The more important aspect is that after the bones are bent, the rib cage will be affected, so the ability of the lungs to breathe and the rib cage to expand will be limited. Therefore, people who bend over their humpbacks may become more likely to suffer from respiratory problems when they are old.
Another point, in fact, the most terrible place for osteoporosis to cause a fracture is a hip fracture. Many elderly people may be bedridden for a lifetime because of a hip fracture. Because he had to lie down for a long time after his hip fracture, and he was prone to complications like aspiration pneumonia when he was lying down. Fractures of the hip joint caused by osteoporosis have a particularly significant impact on the quality of life and longevity of patients.

How to prevent osteoporosis?

    Get more sun and get more calcium. Its benefits are firstly preventive and secondly therapeutic. If you haven't got osteoporosis, you need to prevent osteoporosis. More sun exposure and more calcium supplementation are preventive. Everyone can understand the supplement of calcium. The calcium that is eaten enters the gastrointestinal tract and may be deposited on the bones. The advantage of sun exposure is that the sun can shine on the skin through ultraviolet rays, and the skin synthesizes vitamin D. Vitamin D is very important for the absorption of calcium. We took calcium tablets. Can calcium tablets get into the blood? It needs vitamin D help. So if you don't have vitamin D and eat calcium alone, the effect is very poor. Now it is summer, and the sun is more abundant. It is a very good time for us to let the skin synthesize vitamin D. By the winter, the sun is scarce and the weather is not as good as it is now, the effect of sun exposure is very poor. So in winter, we may need to take some vitamin D orally . Vitamin D is a basic measure of osteoporosis treatment, which is a continuous and lifelong treatment measure.

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