SOBRE A OSTEOPOROSE
A osteoporose, ou osso poroso, é uma doença caracterizada por baixa massa óssea e deterioração estrutural do tecido ósseo, levando à fragilidade óssea e um aumento da susceptibilidade a fraturas, especialmente do quadril, coluna e punho, embora qualquer osso pode ser afetado.
A osteoporose é uma grande ameaça à saúde pública, com um número estimado de 44 milhões de americanos, ou 55 por cento das pessoas de 50 anos de idade ou mais velhos. Nos E.U. hoje, 10 milhões de pessoas são estimadas para já têm a doença e quase 34 milhões têm tendencia a ter baixa massa óssea, colocando-os em maior risco para a osteoporose. Dos 10 milhões de americanos com osteoporose, 8 milhões são mulheres e 2 milhões são homens. Uma em cada duas mulheres e um em cada quatro homens com idade acima de 50 terão uma fratura relacionadas à osteoporose. bEmbora a osteoporose é geralmente considerada como doença de uma pessoa mais velha, ela pode atacar em qualquer idade. 80% das pessoas afectadas pela osteoporose são mulheres. 20% das pessoas afectadas pela osteoporose são homens.
Três por cento dos homens latino-americanos com mais de 50 anos são estimados para ter osteoporose, e 23% são estimados para ter a baixa massa óssea.
Fraturas
Uma em cada duas mulheres e um em cada quatro homens com idade acima de 50 terão uma fratura osteoporose-relacionadas em sua vida restante.
A osteoporose é responsável por mais de 1,5 milhão de fraturas anualmente, incluindo:
mais de 300.000 fraturas de quadril, e aproximadamente
700.000 fraturas vertebrais;
250.000 fraturas de punho
300.000 fraturas em outros locais.
Custos
A estimativa é de gastos diretos (hospitais e lares de idosos) para as fraturas osteoporóticas e associadas foi de US $ 17 bilhões em 2001 ($ 47 milhões todos os dias), e o custo está subindo.
Sintomas
A osteoporose é muitas vezes chamada de "doença silenciosa", pois a perda óssea ocorre sem sintomas. As pessoas podem não saber que tem osteoporose até que seus ossos tornam-se tão fracos que uma deformação súbita, colisão ou queda cause uma fratura ou uma vértebra em colapso. Vértebras Colapsadas pode inicialmente ser sentido ou visto sob a forma de dor lombar severa, perda de altura, ou deformidades da coluna vertebral, como cifose, ou postura inclinada.
Fatores de Risco
Certas pessoas são mais propensas a desenvolver osteoporose do que outros. Fatores que aumentam a probabilidade de desenvolver osteoporose são chamados "fatores de risco." Esses fatores de risco incluem:
História pessoal de fratura após os 50 anos
Massa óssea baixa
Ser do sexo feminino
Ser magro e / ou com uma pequena estatura
A idade avançada
A história familiar de osteoporose
Deficiência de estrogênio, como resultado da menopausa, especialmente no início ou cirurgicamente induzido
Ausência anormal de períodos menstruais (amenorréia)
Anorexia nervosa
Baixa ingestão de cálcio
A deficiência de vitamina D
Uso de certos medicamentos, como corticóides e anticonvulsivantes
Presença de certas condições médicas crônicas
Níveis baixos de testosterona em homens
Um estilo de vida sedentário
Tabagismo atual
O uso excessivo de álcool
Ser caucasiana ou asiática, embora Africano-americanos e hispânicos americanos estão em risco significativo
As mulheres podem perder até 20 por cento da sua massa óssea nos cinco a sete anos após a menopausa, tornando-os mais suscetíveis à osteoporose.
Testes especializados chamados testes de densidade óssea pode medir a densidade óssea em vários locais do corpo. Um teste de densidade óssea pode:
Detectar a osteoporose antes que uma fratura ocorra.
Prever suas chances de fratura no futuro.
DMO (DENSITOMETRIA ÓSSEA) pode determinar a taxa de perda óssea e / ou controlar os efeitos do tratamento se o teste é realizado em intervalos de um ano ou mais.
Prevenção
Por volta de 20 anos, a mulher já adquiriu 98% da sua massa óssea. Construir ossos fortes durante a infância e na adolescência pode ser a melhor defesa contra o desenvolvimento de osteoporose mais tarde. Há quatro etapas, que juntos, pode otimizar a saúde dos ossos e ajudar a prevenir a osteoporose. Eles são:
Uma dieta equilibrada, rica em cálcio e vitamina D;
Peso-rolamento exercício;
Um estilo de vida saudável sem fumo ou o consumo excessivo de álcool
Teste de densidade óssea e medicação, quando necessário.
Fraturas
Os locais mais comuns de fraturas relacionadas à osteoporose são do quadril, coluna, punho e costelas, embora a doença pode afetar qualquer osso do corpo.
A taxa de fraturas de quadril é de duas a três vezes maior em mulheres do que homens, no entanto, a mortalidade um ano após uma fratura de quadril é quase duas vezes mais alta para os homens.
O risco de uma mulher de fraturar o quadril é igual ao seu risco de câncer combinado de mama, útero e câncer de ovário.
Em 1991, cerca de 300.000 norte-americanos e mais de 45 anos foram internados em hospitais com fraturas de quadril. A Osteoporose foi a causa básica da maioria dessas lesões.
Uma média de 24 por cento dos pacientes com fratura de quadril com 50 anos ou mais morrem no ano seguinte à fratura.
Um quarto dos que estavam em ambulatório antes da sua fratura do quadril requerem cuidados a longo prazo depois.
Em seis meses após a fratura de quadril, apenas 15 por cento dos doentes com fratura da bacia pode andar em uma sala sem ajuda.
As mulheres brancas de 65 anos ou mais têm o dobro da incidência de fraturas que mulheres Africano-americano.
Medicações
Embora não haja cura para a osteoporose, os seguintes medicamentos são aprovados pelo FDA para mulheres pós-menopáusicas para prevenir e / ou tratar a osteoporose:
Bifosfonatos: Alendronato (marca Fosamax ®) e risedronato (Actonel ® marca)
Calcitonina (marca Miacalcin ®)
Estrógeno / terapia hormonal:
Estrógenos (nomes de marcas, tais como Climara ® Estrace ®, Estraderm ®, Estratab, Ogen ®, Ortho-Est ®, Premarin ®, Vivelle ®, e outros)
Estrogênios e progestogênios (nomes de marcas, tais como Activella ™, ® Femhrt, Premphase ®, ® Prempro, e outros)
Hormônio da paratireóide: paratormônio (PTH (1-34), marca Forteo ®)
Moduladores selectivos do receptor (SERMs): Raloxifeno (marca Evista ®)
O alendronato é aprovado como um tratamento para a osteoporose em homens e é aprovado para o tratamento induzido por glucocorticóides (esteróides) osteoporose em homens e mulheres. Risedronato foi aprovado para prevenção e tratamento da osteoporose induzido por glicocorticóides em homens e mulheres.
Paratormônio é aprovado para o tratamento da osteoporose em homens que estão em alto risco de fratura.
Tratamentos sob investigação incluem fluoreto de sódio, metabólitos da vitamina D, e outros bifosfonatos e moduladores seletivos de receptor de estrogênio.
Referências: ONIH Osteoporosis and Related Bone Diseases National Resource Center
ABOUT OSTEOPOROSIS
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially hip, spine and wrist, although any bone can be affected.
Osteoporosis is a major public health threat, with an estimated 44 million Americans, or 55 percent of people 50 years of age or older. In the U.S. today, 10 million people are estimated to already have the disease and almost 34 million have a tendency to have low bone mass, placing them at greater risk for osteoporosis. Of the 10 million Americans with osteoporosis, eight million are women and 2 million are men. One in two women and one in four men over age 50 will have a fracture related to osteoporosis. bEmbora osteoporosis is generally considered a disease of an older person, it can strike at any age. 80% of those affected by osteoporosis are women. 20% of those affected by osteoporosis are men.
Three percent of Hispanic men over 50 years are estimated to have osteoporosis, and 23% are estimated to have low bone mass.
Fractures
One in two women and one in four men over age 50 will have an osteoporosis-related fracture in their remaining life.
Osteoporosis is responsible for more than 1.5 million fractures annually, including:
More than 300,000 hip fractures, and approximately
700,000 vertebral fractures;
250,000 wrist fractures
300 000 fractures at other sites.
Costs
An estimated direct expenditures (hospitals and nursing homes) for osteoporotic and associated fractures was $ 17 billion in 2001 ($ 47 million every day), and the cost is rising.
Symptoms
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height or spinal deformities such as kyphosis or stooped posture.
Risk Factors
Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis are called "risk factors." These risk factors include:
Personal history of fracture after 50 years
Low bone mass
Being female
Being thin and / or with a small stature
Advanced age
Family history of osteoporosis
Estrogen deficiency as a result of menopause, especially in early or surgically induced
Abnormal absence of menstrual periods (amenorrhea)
Anorexia nervosa
Low intake of calcium
A deficiency of vitamin D
Use of certain medications such as corticosteroids and anticonvulsants
Presence of certain chronic medical conditions
Low testosterone levels in men
A sedentary lifestyle
Current smoking
Excessive use of alcohol
Being Caucasian or Asian, while African-Americans and Hispanic Americans are at significant risk
Women can lose up to 20 percent of their bone mass in five to seven years after menopause, making them more susceptible to osteoporosis.
Specialized tests called bone density tests can measure bone density in various body sites. A bone density test can:
Detect osteoporosis before a fracture occurs.
Predict your chances of fracture in the future.
BMD (densitometry) can determine the rate of bone loss and / or monitor the effects of treatment if the test is conducted at intervals of one year or more.
Prevention
Around 20 years, she has already acquired 98% of their bone mass. Building strong bones during childhood and adolescence may be the best defense against developing osteoporosis later. There are four steps, which together can optimize bone health and help prevent osteoporosis. They are:
A balanced diet rich in calcium and vitamin D;
Weight bearing exercise;
A healthy lifestyle without smoking or excessive alcohol consumption
Bone density test and medication when necessary.
Fractures
The most common sites of fractures related to osteoporosis are the hip, spine, wrist and ribs, although the disease can affect any bone in the body.
The rate of hip fractures is two to three times higher in women than men, however, mortality one year after a hip fracture is nearly twice as high for men.
The risk of a woman of hip fracture equals her combined risk of breast cancer, uterine and ovarian cancer.
In 1991, about 300,000 Americans and more than 45 years were admitted to hospitals with hip fractures. Osteoporosis was the underlying cause of most of these injuries.
An average of 24 percent of hip fracture patients aged 50 or older die in the year following fracture.
A quarter of those who were ambulatory before their hip fracture requires long-term care afterward.
In six months after hip fracture, only 15 percent of patients with fracture of the pelvis can walk into a room unaided.
White women age 65 or older have twice the incidence of fractures as African-American women.
Medications
Although there is no cure for osteoporosis, the following drugs are approved by the FDA for postmenopausal women to prevent and / or treat osteoporosis:
Bisphosphonates: Alendronate (brand name Fosamax ®) and risedronate (Actonel ® mark)
Calcitonin (brand name Miacalcin ®)
Estrogen / hormone therapy:
Estrogens (brand names, such as climate ® Estrace ®, Estraderm ®, Estratab, Ogen ®, Ortho-Est ®, Premarin ®, Vivelle ® and others)
Estrogens and Progestins (brand names, such as Activella ™, Femhrt ®, Premphase ®, Prempro ®, and others)
Parathyroid hormone: Parathyroid hormone (PTH (1-34), Mark Forteo ®)
Selective receptor modulators (SERMs): Raloxifene (brand name Evista ®)
Alendronate is approved as a treatment for osteoporosis in men and is approved for the treatment induced by glucocorticoids (steroids) osteoporosis in men and women. Risedronate is approved for prevention and treatment of glucocorticoid-induced osteoporosis in men and women.
Parathyroid hormone is approved for the treatment of osteoporosis in men who are at high risk of fracture.
Treatments under investigation include sodium fluoride, vitamin D metabolites, and other bisphosphonates and selective modulators of estrogen receptor.
ABOUT OSTEOPOROSIS
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially hip, spine and wrist, although any bone can be affected.
Osteoporosis is a major public health threat, with an estimated 44 million Americans, or 55 percent of people 50 years of age or older. In the U.S. today, 10 million people are estimated to already have the disease and almost 34 million have a tendency to have low bone mass, placing them at greater risk for osteoporosis. Of the 10 million Americans with osteoporosis, eight million are women and 2 million are men. One in two women and one in four men over age 50 will have a fracture related to osteoporosis. bEmbora osteoporosis is generally considered a disease of an older person, it can strike at any age. 80% of those affected by osteoporosis are women. 20% of those affected by osteoporosis are men.
Three percent of Hispanic men over 50 years are estimated to have osteoporosis, and 23% are estimated to have low bone mass.
Fractures
One in two women and one in four men over age 50 will have an osteoporosis-related fracture in their remaining life.
Osteoporosis is responsible for more than 1.5 million fractures annually, including:
More than 300,000 hip fractures, and approximately
700,000 vertebral fractures;
250,000 wrist fractures
300 000 fractures at other sites.
Costs
An estimated direct expenditures (hospitals and nursing homes) for osteoporotic and associated fractures was $ 17 billion in 2001 ($ 47 million every day), and the cost is rising.
Symptoms
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height or spinal deformities such as kyphosis or stooped posture.
Risk Factors
Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis are called "risk factors." These risk factors include:
Personal history of fracture after 50 years
Low bone mass
Being female
Being thin and / or with a small stature
Advanced age
Family history of osteoporosis
Estrogen deficiency as a result of menopause, especially in early or surgically induced
Abnormal absence of menstrual periods (amenorrhea)
Anorexia nervosa
Low intake of calcium
A deficiency of vitamin D
Use of certain medications such as corticosteroids and anticonvulsants
Presence of certain chronic medical conditions
Low testosterone levels in men
A sedentary lifestyle
Current smoking
Excessive use of alcohol
Being Caucasian or Asian, while African-Americans and Hispanic Americans are at significant risk
Women can lose up to 20 percent of their bone mass in five to seven years after menopause, making them more susceptible to osteoporosis.
Specialized tests called bone density tests can measure bone density in various body sites. A bone density test can:
Detect osteoporosis before a fracture occurs.
Predict your chances of fracture in the future.
BMD (densitometry) can determine the rate of bone loss and / or monitor the effects of treatment if the test is conducted at intervals of one year or more.
Prevention
Around 20 years, she has already acquired 98% of their bone mass. Building strong bones during childhood and adolescence may be the best defense against developing osteoporosis later. There are four steps, which together can optimize bone health and help prevent osteoporosis. They are:
A balanced diet rich in calcium and vitamin D;
Weight bearing exercise;
A healthy lifestyle without smoking or excessive alcohol consumption
Bone density test and medication when necessary.
Fractures
The most common sites of fractures related to osteoporosis are the hip, spine, wrist and ribs, although the disease can affect any bone in the body.
The rate of hip fractures is two to three times higher in women than men, however, mortality one year after a hip fracture is nearly twice as high for men.
The risk of a woman of hip fracture equals her combined risk of breast cancer, uterine and ovarian cancer.
In 1991, about 300,000 Americans and more than 45 years were admitted to hospitals with hip fractures. Osteoporosis was the underlying cause of most of these injuries.
An average of 24 percent of hip fracture patients aged 50 or older die in the year following fracture.
A quarter of those who were ambulatory before their hip fracture requires long-term care afterward.
In six months after hip fracture, only 15 percent of patients with fracture of the pelvis can walk into a room unaided.
White women age 65 or older have twice the incidence of fractures as African-American women.
Medications
Although there is no cure for osteoporosis, the following drugs are approved by the FDA for postmenopausal women to prevent and / or treat osteoporosis:
Bisphosphonates: Alendronate (brand name Fosamax ®) and risedronate (Actonel ® mark)
Calcitonin (brand name Miacalcin ®)
Estrogen / hormone therapy:
Estrogens (brand names, such as climate ® Estrace ®, Estraderm ®, Estratab, Ogen ®, Ortho-Est ®, Premarin ®, Vivelle ® and others)
Estrogens and Progestins (brand names, such as Activella ™, Femhrt ®, Premphase ®, Prempro ®, and others)
Parathyroid hormone: Parathyroid hormone (PTH (1-34), Mark Forteo ®)
Selective receptor modulators (SERMs): Raloxifene (brand name Evista ®)
Alendronate is approved as a treatment for osteoporosis in men and is approved for the treatment induced by glucocorticoids (steroids) osteoporosis in men and women. Risedronate is approved for prevention and treatment of glucocorticoid-induced osteoporosis in men and women.
Parathyroid hormone is approved for the treatment of osteoporosis in men who are at high risk of fracture.
Treatments under investigation include sodium fluoride, vitamin D metabolites, and other bisphosphonates and selective modulators of estrogen receptor.
