Osteoporosis

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Metabolic Bone Disorder

• Osteoporosis

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Osteoporosis

• Characteristics
• Reduction in bone density
• Changes in bone structure
• Increased prevalence for fractures
• Normal bone turnover is altered
• Rate of absorption is greater than bone
  formation? reduce total bone mass
• Making bone porous, brittle and fragile

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Osteoporosis Facts

• Anyone can develop osteoporosis,
• Common in older Caucasian women.
• Occurs after menopause
• As many as half of all women and a quarter of men
  older than 50 will break a bone due to
  osteoporosis.

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Pathophysiology

• Loss of bone is universal associated with aging
• After the peak bone mass is achieved (4th decade)
• ? Calcitonin
• Normally Inhibits bone reabsorption and promotes
  bone loss

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Pathophysiology

• ? Estrogen (with aging)
• Normally Inhibits bone breakdown
• PTH ? with aging
• Increases bone turnover and reabsortion
• The result is net loss of bone mass over time

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Risk Factors

• Female
• Increased age
• Low weight and body mass index
• Family history of osteoporosis
• Estrogen deficiency or menopause
• Caucasion, non-hispanic or Asian woman
• osteopenia, (low bone mass)
• Other diseases

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Lifestyle Risk Factors

• Diet low in calcium and vitamin D
• Cigarette smoking
• Use of alcohol and or caffeine
• Lack of weight bearing exercises
• Lack of sunlight exposure

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Assessment and Diagnosis

• Routine xray (25-40 bone loss)
• Dual energy xray absorptiometry (DEXA)
• BMD results
• Lab studies
• Calcium, phosphate, alk. Phos., sed rate

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Medical Management

• Calcium and vitamin D rich diet
• Calcium supplements
• Caltrate, citracal, vitamin C beverages,
• Regular weight bearing exercise
• Aerobic exercise

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Pharmacological Therapy

• Natural or surgical menopause
• Estrogen and progerone
• Selective estrogen receptor modulators (SERMs)
  (preserves BMD)
• raloxufene (Evista)

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Pharmacological Therapy

• biphosphonates (reduce spine and hip fx)
• alendronate (Fosamax)
• risedronate (Actonel)
• Antilipid drugs (statins)
• Promotes bone growth
• Reduces the incidence of fx

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THE END