Menopause and Osteoporosis PDF

Osteoporosis  Reduction of bone mass density with micro- architectural alteration with increase bone fragility.  Imbalance between osteoclastic & osteoblastic activity ( defective remodeling )  What is Osteoporosis?  Loss in total mineralized bone...

Osteoporosis  Reduction of bone mass density with micro- architectural alteration with increase bone fragility.  Imbalance between osteoclastic & osteoblastic activity ( defective remodeling )  What is Osteoporosis?  Loss in total mineralized bone  Disruption of normal balance of bone breakdown and build up  Osteoclasts: bone resorption, stimulated by PTH  Calcitonin: inhibits osteoclastic bone resorption  Major mechanisms: ◦ Slow down of bone build up: osteoporosis seen in older women ◦ Accelerated bone breakdown: postmenopausal  Normal loss 0.5% per year after peak in 20s  Up to 5% loss/year during first 5 years after menopause PTH= Parathyroid Hormone  RiskFactors Risk Factors for for Osteoporosis Osteoporosis Things you can’t change 1 Gender 2 Heredity 3 Age 4 Fracture history 5 Medical conditions (e.g. Hyper-thyroidism, parathyroidism) 6 Medications for chronic diseases (e.g. steroids) Risk RiskFactors for Osteoporosis Factors for Osteoporosis Things you can change 1 Calcium consumption 2 Vitamin D intake 3 Quit smoking or vaping 4 Alcohol consumption 5 Physical activity 6 Posture 7 Low body weight (BMI < 20) 83 Some medications Complications of Osteoporosis fractures Most common sites of fracture are the vertebrae, femur neck and distal radius.  One third of women will suffer vertebral fracture after 65 years of age and hip fracture by age 90.  Hip fractures are associated with 5-20% mortality rate  Diagnosis of Osteoporosis Dual energy X-ray absorptiometry (DEXA)  The fall of Bone mass density (BMD) > 2.5 standard deviation below the mean for young adults ( t-score)  How to interpret the BMD  T score: standard deviation of the BMD from the average sex matched 35-year-old  Z score: less used; standard deviation score compared to age matched controls  WHO: Osteoporosis:T score