Human bone mass peaks around the age of 30 and begins to decline after the age of 40. In children and adolescents, attention should be paid to calcium and vitamin D supplementation to achieve an ideal peak bone mass; During the period between 20 and 40 years old, say goodbye to bad lifestyle habits such as alcoholism, smoking, high intake of caffeine and carbonated drinks, excessive weight loss, etc., and maintain peak bone mass; After the age of 40, rational use of drugs to prevent and treat osteoporosis.
A lot of older people
Both have osteoporosis
As the population ages, the prevalence of osteoporosis as a major chronic metabolic disease is climbing. According to the "Guidelines for the Diagnosis and Treatment of Primary Osteoporosis (2022)", epidemiological surveys show that the prevalence of osteoporosis in women over 65 years old has reached more than 51%, which means that half of elderly women are osteoporosis patients. At the same time, 1 in 10 men over the age of 65 suffer from osteoporosis.
Osteoporosis has no obvious symptoms in the early stages, so it is also known as a "quiet epidemic" and is easy to ignore. With the aggravation of the disease, patients will have bone pain, decreased mobility, short height, fracture under slight external force, and even acute cardiovascular and cerebrovascular events, deep vein thrombosis, pneumonia, bedsores, etc., which have a high disability and mortality rate.
For osteoporosis
Many people have misconceptions
Myth 1: Osteoporosis is natural aging
Many people think that osteoporosis is a natural aging phenomenon and do not consider it a disease. Some elderly people are getting shorter and shorter, and in fact they may have developed thoracic or lumbar compression due to osteoporosis. Osteoporosis is not a natural phenomenon, it is a disease and it can be diagnosed, prevented, and treated.
Myth 2: The treatment of osteoporosis is calcium supplementation
There are very effective drugs that inhibit bone loss, promote bone formation, and promote both bone loss and bone formation. It's not just about calcium and vitamin D.
Myth 3: Drinking some bone broth can replenish calcium
There are also many people who think that drinking bone broth can cure osteoporosis, but in fact, the calcium in the bones is difficult to dissolve, and the bone broth is more fat and purines, which is not helpful for calcium supplementation.
Myth 4: Take white as beauty and over-protect the sun
In summer, many people have strict sun protection, covering them from head to toe. Vitamin D is synthesized by the skin, and if you stay away from sunlight, the body will be severely deficient.
Glucocorticoids are easy
Causes osteoporosis
Osteoporosis is divided into primary and secondary, and there are many secondary causes, which can be caused by a series of diseases or drugs that affect bone metabolism, among which, the most common drug that causes osteoporosis is glucocorticoids.
Glucocorticoidal osteoporosis is particularly common, and it occurs gradually with the use of hormones, but patients and doctors often do not pay attention to it, and some patients do not receive any osteoporosis treatment, and they may focus more on treating the underlying condition.
According to the 2020 edition of the Chinese Expert Consensus on the Prevention and Treatment of Glucocorticoid-induced Osteoporosis, bone loss in patients with glucocorticoid-induced osteoporosis is most obvious in the first year, with a loss of 12%-20%, and a loss of about 3% per year thereafter. Long-term use of glucocorticoids increases the risk of vertebral fracture by 5.9 times and hip fracture by 5 times.
For drug-induced osteoporosis, it is recommended to reduce the dosage and shorten the course of treatment of drugs that affect bone metabolism as much as possible under reasonable circumstances, and at the same time, strong and effective drugs should be given to prevent and treat osteoporosis and reduce the risk of fracture.
In addition to calcium supplementation,
Osteoporosis needs more scientific treatment
Calcium and vitamin D are good for bones, but it's only the basic treatment for osteoporosis. On this basis, it is necessary to combine strong and effective drugs that inhibit bone loss and promote bone formation, so that bone density can really increase and reduce the risk of fracture. If the patient has the following conditions, it is necessary to combine strong and effective treatment drugs: first, the fracture has been broken under slight external force; The second is to measure bone density, and the T score is below -2.5, which is consistent with osteoporosis, and the third is that the T value is between -1 and -2.5, and there is osteopenia, but the risk of fracture is high as measured by the FRAX score.
In order to change the lack of drugs for the treatment of glucocorticoid-induced osteoporosis, a variety of biologically targeted drugs have been launched in the past 10 years. For example, the RANKL inhibitor denosumab can inhibit the production and activity of osteoclasts, so that bone destruction is reduced, the rate of bone loss decreases, and bone density increases with the process of treatment, and the risk of fracture decreases. This medicine is injected every 6 months and is more convenient for patients.
It is understood that denosumab has been approved in China for the treatment of osteoporosis in postmenopausal women and osteoporosis in men, and has been eligible for medical insurance reimbursement.
Editor: Li Ling
Source: Health Times
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