Page 68 - GALENIKA MEDICAL JOURNAL

Risk factors and complications (raloxifene, lasofoxifene, arzoxifene), calcium and vitamin
of osteoporosis D supplements, the application of monoclonal antibodies,
and hormone therapy (phytoestrogens, estrogens, testoste-
Risk factors for osteoporosis include: female gender, rone) 27-30 .
age 50 and older, caucasian, genetic predisposition, low he-
ight, malnutrition, physical inactivity, late menarche, early
menopause, conditions of estrogen and androgen deficien- Preventive measures
cy, alcohol consumption, smoking cigarettes, calcium-poor
diet, and the use of certain medications (steroids, insulin, Lifestyle changes and non-pharmacological measures
anticonvulsants, chemotherapeutics, heparin). are crucial for maintaining healthy bones. Physical activity,
adequate calcium and vitamin D-rich diet, avoiding smo-
Osteoporosis is the leading cause of bone fractures in king, and limiting alcohol consumption are of immense im-
the elderly population and the primary cause of all fractures portance for individuals of all ages, especially in older age.
(over 80% of cases of all fractures in individuals over 50 ye- Implementing these measures yields positive outcomes
ars old). If complete healing is not achieved, chronic painful even in patients with established osteoporosis, leading to
conditions, limited mobility, and in some cases even death increased bone strength and reduced risk of fractures.
(fractures of the vertebrae and hips) can occur .
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The goals of preventive strategies include optimizing
the development of the skeletal system and achieving peak
Diagnosis of osteoporosis bone mass during skeletal maturity, preventing secondary
causes of bone loss, preserving the structural integrity of
Bone densitometry measures the difference in the bones, and preventing fractures.
absorption of gamma or X-rays, ultrasound, or laser in
bones and soft tissue. It provides the opportunity to mea- Balanced and healthy nutrition ensures adequate in-
sure bone mineral content (g) and indirectly measure bone take of calcium and vitamin D. Malnutrition, anorexia, and
density (g/cm ). excessive aerobic activity in young women lead to delayed
2
menarche and lower bone mass compared to peers. A si-
Dual-energy X-ray absorptiometry (DXA) is a widely used milar situation is observed in adults undergoing restrictive
method that offers exceptional resolution and precision. diets and surgical weight loss methods. A balanced intake
The scanning process is brief, meaning whole-body mine- of protein (the recommendation is that daily intake should
ral content measurement is fast, reliable, safe, and highly be 0.8 g/kg of body weight) helps minimize bone loss even
reproducible, thereby reducing issues with superimposi- in patients with established osteoporosis .
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tion with surrounding soft tissues. The apparatus utilizes
X-rays as an energy source. DXA measurements of the hip The fundamental aspect of osteoporosis prevention and
and spine represent a widespread standard in osteoporosis treatment is calcium. For women over 50 years of age, the
diagnosis. Measurement via DXA and laser absorptiometry recommended daily calcium intake is 1.200 mg (through
(Dual-energy X-ray Laser, DXL) of the calcaneus bone ser- diet and supplementation, if conducted). In situations whe-
ves as an alternative to DXA. This technique was developed re dietary intake does not provide sufficient calcium, calci-
to avoid measurement errors associated with surrounding um supplementation is necessary. Data show that the daily
soft tissue during DXA. dietary intake for most patients is up to 600 mg, which is
only half of the required daily dose. If supplementation is
Quantitative Computed Tomography (QCT) measures used, for optimal absorption, the calcium dose should not
thin cross-sectional slices. With the aid of computer analysis, exceed 500 mg per dose. It has been proven that calcium
bone mineral density is measured, and the density of trabe- supplementation increases bone mineral density, but there
cular and cortical bone is particularly assessed. is no scientific evidence that its use alone, without simul-
taneous vitamin D supplementation, reduces the risk of
Quantitative Ultrasonography (QUS) is a method of
bone densitometry measured by ultrasound. Its advantage fractures. Calcium supplementation is safe for users. The
lies in avoiding radiation, and the apparatus is easily por- risk of nephrolithiasis (kidney stone formation) in patients
table. However, measurements are not as precise as with on supplementation is minimally higher compared to the
other imaging techniques 25, 26 . general population (the risk of nephrolithiasis in patients on
supplementation is 2.5%, while in the general population,
this risk is 2.1%) .
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Treatment of osteoporosis Calcium supplementation should be accompanied by
Contemporary pharmacological treatment for oste- vitamin D. Many, otherwise healthy individuals have signi-
oporosis includes the use of bisphosphonates (alendro- ficantly lower serum levels of 25(OH)D compared to the
nate, etidronate, ibandronate, risedronate, zoledronic optimum level. This is primarily due to inadequate dietary
acid), Selective Estrogen Receptor Modulators (SERMs) intake because vitamin D is not widely available in foods.
It is found in fish oil, cereals, and bread. According to the

66 DOI: 10.5937/Galmed2409072B