OSTEOPOROSIS

Osteoporosis



Introduction

Osteoporosis characterized by loss of bone strength predisposing to fracture. In most cases, bones become brittle due to lack of calcium, the phosphorus and other minerals. Osteoporosis causes bones to become porous and more likely to fracture during a fall banal, which in normal times would have been inconsequential. it is not a disease but a natural process most often associated with aging. Osteoporosis is a main risk factor for fragility fractures. In the clinic, the diagnosis of osteoporosis based on bone densitometry(Adami and Bufalino , 1997, 121). "Fragility fracture is a serious public health problem in the world. The risk of fracture determined by genetic and nongenetic clinical risk factors," researchers in Sydney, Australia report. This is also the main technique when investigating effects of therapies on patients. It is therefore, important to evaluate how well measures of bone mineral density (BMD) predict fracture.

Epidemiology

In Westernized countries, anorexia nervosa, bulimia nervosa, and related eating disorders constitute the third most common chronic illness in adolescent females, and the incidence of eating disorders in this age group continues to rise.14 It estimated that anorexia nervosa occurs in 1 out of 200 adolescent females between the ages of 15 and 19 years. Postmenopausal osteoporosis has attained the status of a major epidemic and most women with it present with a fracture as the first indication of the disease. In the USA, osteoporosis and treatment of osteoporosis related fractures costs estimated to be in excess of $18 billion a year. The yearly cost of treating osteoporosis related femoral fractures in Saudi Arabia as SAR4.27 billion a year. Proper interventions could reduce this cost tremendously. (Todd, 2003, 323)

Glucocorticoids considered an important component of therapy for a variety of medical conditions including autoimmune, rheumatic, pulmonary and gastrointestinal disorders. Patients treated with gluco corticoids are at risk for many adverse complications. (Ailinger, 2005, 136)

Aetiology

Evidence indicates that GIOP is the most common cause of secondary osteoporosis, leading to fractures in 30% to 50% of patients taking chronic glucocorticoids. However, studies showed that many patients treated with glucocorticoids are not properly evaluated and do not receive prophylaxis or treatment to prevent bone loss. (Adami, 2001, 20).



Who affected?

In most cases, osteoporosis occurs in people aged 65 and over, but it can occur earlier. The age of 50 years at the end of their lives, 4 of 10 Caucasian women will suffer a fracture due to osteoporosis. The bones of the hip and wrist and spine ,are the ones who suffer most often a fracture due to osteoporosis. (Quebec, 2008,151).

Pathophysiology

It includes many of the reports focus on osteoblastic activity. This is an expanding field, and we are now beginning to understand the processes behind insufficient osteoblastic activity. This is a crucial part of bone loss since bone resorption with adequate coupling of bone formation does not lead to osteoporosis. In several areas of metabolic bone diseases, we now see that impaired osteoblastic activity is a major component (Sedlak and Jones, 2000, ...