Osteoporosis

Bones of an 89-year-old woman with osteoporosis.

Osteoporosis is a systemic disease of the musculoskeletal system, namely the bone component. In the presence of this disease, changes occur not only in the density of the bone, but also in its architectonics (structure). When bones change in structure, they become more fragile, and the more pronounced osteoporosis, the more likely it is to get injured even with a small load. In extreme stages, "spontaneous" fractures are also possible.

This ailment has been known to mankind since ancient times. Typical musculoskeletal changes have been found as far back as the remains of North American Native American tribes dated to 2500 BC. The Inca Museum in Peru has an exhibit of bones with the disease.

Morbidity and mortality

In 2020, osteoporosis affects 200 million women and 120 million men worldwide. Over the age of 50, one in two women and one in three men are at risk of osteoporosis. According to WHO forecasts, by 2035 the increase in the number of fractures of the proximal hip in men will increase by 36%, in women - by 40%.

"Deaths from stroke and osteoporosis are in comparable values. This disease spreads at a catastrophic rate. In Russia, 14.4 million people suffer from osteoporosis, and only for 430 thousand pathogenetic therapy is prescribed, "said Alexander Rozanov, senior researcher at the Russian Gerontological Scientific and Clinical Center.

Risk factors

The main risk factors affecting the development of osteoporosis as of 2020 are:

• reduced calcium intake with food,
• low physical activity,
• excess alcohol consumption and
• smoking.

The risk of hip fracture is 44% higher in smokers by reducing bone mineral density. It is the influence of combustion products, and not nicotine, that reduces the level of vitamin D3 in the body, which disrupts the metabolic processes of calcium.

"Smoking significantly and quite negatively affects the prognosis of the course of the disease. It is important to note that this is not due to the influence of nicotine, but due to the influence of combustion products. Combustion products, due to the influence on the cytochrome system, disrupt the exchange of vitamin D and increase the breakdown of estrogens. There is an increase in oxidative stress, chronic inflammation and the effect on the body of heavy metals. And mortality from osteoporosis is comparable to mortality from stroke, "said Ekaterina Dudinskaya from the Russian Gerontological Research and Clinical Center.

Tobacco smoke toxins transform mitochondria into giant mitochondria, which by the onset of old age causes diseases of the musculoskeletal system.

"6 hours of exposure to tobacco smoke muscle results in a significant loss of functional muscle tissue status. Smoking leads to a significant increase in the risk of osteoporosis. Cigarette smoke itself increases inflammation in the muscles, which is especially dangerous with a lack of vitamin D and low physical activity, "said Anton Naumov, professor at MGMSU, doctor of medical sciences.

At the same time, according to the professor, only 10-15% of patients of older age groups will follow the doctor's instructions about limiting smoking and increasing physical activity. Even doctor-prescribed statins take just 25% of patients.

Importance of vitamin D in disease prevention

Despite the fact that the problem of treating this disease has been studied for 150 years, it remains chronic to this day. That is why, doctors recommend focusing on preventive measures. Inga Evgenievna Popova, Candidate of Medical Sciences, Endocrinologist of the JSC Medicine Clinic (Clinic of Academician Roitberg), talks about preventive measures:

'One of the main areas of prevention of osteoporosis is to ensure an adequate intake of calcium and vitamin D salts, as this contributes to maintaining bone density. Vitamin D is needed to improve calcium absorption and maintain bone health. A lack of this vitamin plays an important role in the development of osteoporosis, as well as many other significant chronic diseases, including type 2 diabetes mellitus, some types, cancer cardiovascular diseases, autoimmune and infectious diseases. '

Vitamin D deficiency is usually the result of insufficient solar insolation or insufficient dietary intake. It is worth noting that only 20% of this vitamin comes from food, the remaining 80% are synthesized in the skin under the influence of ultraviolet B-band light. The list of causes contributing to the development of deficiency also discusses the fact that people have begun to work more indoors and do not have the opportunity to be in the sun every day, thus creating a supply of vitamin D.

The list of foods containing vitamin D in the required amount is very limited, so it is difficult to get it from food. Fatty fish varieties (herring, mackerel, salmon) are most rich in vitamin D, and in plant and dairy products, as well as in eggs, it is found in small quantities. Supplemental vitamin D supplementation is an integral part of the prevention and treatment of osteoporosis, as it promotes calcium absorption and bone strengthening.

In addition to a full diet, motor activity, the absence of bad habits and obesity, injury prevention and timely diagnosis are also necessary to preserve bone health.

October 20 - World Osteoporosis Day

By decision of the World Health Organization, October 20 was declared World Osteoporosis Day. The purpose of this day is to raise public awareness of the prevention, diagnosis and treatment of osteoporosis.

Treatment technologies

2023: Russia has created a comprehensive system for the early diagnosis of osteoporosis

Belgorod State University (BelSU) In created a computer program for early personalized diagnostics in osteoporosis coronavirus patients. COVID-19 The press service of the university was told about this in October 2023. More. here