Menopause and Osteoporosis PDF

Summary

This document discusses osteoporosis, particularly in relation to menopause. It covers the definition, risk factors, and diagnosis of the condition. The risk factors are categorized into modifiable and non-modifiable factors. It also mentions complications such as fractures and medical conditions related to osteoporosis.

Full Transcript

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

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