Bones are structures that structurally support muscles, protect vital organs, and store a large portion of the calcium (99%) required for cells to function. The skeletal system disease, which occurs when bone integrity is impaired and especially calcium loss in the bones increases and the bones become weaker and become easily breakable, is called OSTEOPOROSIS (osteoporosis).
Osteoporosis affects both genders and all races. It is a health problem that affects people with increasing frequency and imposes a significant financial burden. Osteoporosis, the incidence of which increases with age, is a natural process of aging. Decrease in calcium absorption from the intestines with age, insufficient calcium intake, decrease in the synthesis of vitamin D in the skin, decrease in the conversion of vitamin D to its active form in the kidneys, and decreasing estrogen levels with menopause cause osteoporosis.
Gender is also important along with age. While the prevalence of osteoporosis in men was 12.1%, it was found to be 57% in women. Secondary causes are often responsible for osteoporosis, which is less common in men:Cortisone drug use, excessive alcohol consumption, decrease in sex hormones, smoking, family history of osteoporosis, vitamin D deficiency, overactive thyroid and parathyroid gland. activity, rheumatological diseases, diabetes, bone marrow cancers.
No cause can be found in 40% of male osteoporosis and these cases are considered primary osteoporosis.
Racial characteristics: The incidence of the disease is 30 -40% lower in black women, bone loss is slower. There are also differences between societies. It is more common in urban societies than in rural areas. . Important reasons for this are; It is a decrease in the activity of urban people, an increase in the frequency of falls and trauma, and nutritional conditions.
Osteoporosis progresses silently and does not cause symptoms until a bone fracture occurs. The most feared consequence is bone fracture. Fractures can occur in all bones. However, fractures are most common in the spine, hip, and wrist. Spine fractures It can be seen with daily activities such as lifting a light load, bending, and coughing violently. Hip fractures often occur as a result of falls. Pulmonary embolism and nosocomial infections secondary to hip fracture increase the risk of death. One-third of patients who develop hip fractures have to spend the rest of their lives as dependents.
Causes affecting the fracture: The sole cause of osteoporotic fractures. The cause is not decreased bone density. Many factors play a role: Calcium-poor nutrition from the womb, in childhood and during growth, genetic factors (vitamin D receptors and bone collagen structure), lack of physical activity, smoking, excessive alcohol consumption, cortisone drug use, deprivation of sunlight and extreme weakness.
The most important environmental factors in bone development are calcium consumption and exercise. Calcium requirement is highest during the years when growth is rapid, during pregnancy and breastfeeding. After reaching peak bone mass, bone mineral density is preserved for a while in both genders. It starts to decrease between the ages of 35 – 45. After menstrual bleeding stops, bone loss increases approximately sevenfold.
Diagnosis:The diagnosis of osteoporosis is diagnosed in the presence of osteoporotic fracture confirmed by examination or radiologically (x-ray) or by bone mineral density (BMD) measurement. is placed. After diagnosis, other systemic diseases that cause bone loss and fractures, apart from osteoporosis, must be investigated.
Who is at risk for osteoporosis?
- Women who went through natural or surgical menopause before the age of 45,
- Those who menstruated after the age of 16,
- Advanced age, female gender,
- Those with thin build and white skin,
- Those who have fractures due to osteoporosis in their parents (especially hip fracture),
- Those who smoke,
- Those who consume too much alcohol,
- Those who have a diet poor in calcium and vitamin D,
- Those who consume excessive caffeine (coffee and cola drinks),
- Sedentary individuals who do not exercise,
- Men with decreased testosterone levels,
- People who use drugs that accelerate bone destruction (cortisone, lithium, thyroid hormone, epilepsy drugs, heparin derivatives),
- Rheumatological diseases (Lupus, Rheumatoid arthritis),
- Chronic kidney diseases,
- Patients with digestive system diseases (colitis and small intestine disease),
- Patients with overactive thyroid gland,
- Patients with overactive parathyroid gland patients,
- Patients with Type -1 Diabetes,
- Patients with overactive adrenal gland,
- Some cancer patients (Multiple myeloma and metastasizing breast and lung tumors)
It is estimated that there are 200 million women with osteoporosis in the world today. Health expenditures and workforce loss due to fracture cases caused by this disease highlight the early diagnosis and prevention of the disease before fractures occur.
In order to keep bones strong and reduce the risk of osteoporosis, we consume calcium in our food regularly every day, starting from childhood, and from sunlight. or vitamin D must be taken from appropriate sources.
The calcium required for bone health cannot be provided without consuming milk and dairy products. These products also contain phosphorus, magnesium, zinc, protein and B group vitamins necessary for the best use of calcium.
Vitamin D is of great importance in absorbing calcium from the intestines and storing it in our bones. It should not be forgotten that most of the daily vitamin D (85%)is obtained from sunlight. Among the natural food sources rich in vitamin D are fatty fish such as mackerel, salmon, sardines, bonito, calf's liver and egg yolk. It is also important to consume adequate and balanced protein for bone health.
The importance of exercise: It is important to exercise regularly at all ages, both to protect against osteoporosis and because of its positive effects on general health. Weight exercises, walking, jogging, dancing, tennis and stair climbing exercises are recommended. Ideally, exercising at least 3-4 times a week. However, it is important for individuals to undergo medical check-up before the exercise program.
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