A 27-year-old girl broke her bones after falling. The doctor said she had osteoporosis. Why does this common disease among the elderly happen to young people?

Ms. Wang, 27 years old, fell down on a slippery road in the rain, and experienced pain in her right upper arm and movement disorder. X-ray showed a fracture of the surgical neck of the right humerus. Why did she break a bone so easily after falling? It turned out that she had osteoporosis at a young age, and the fall caused an osteoporotic fracture.

1. Why do young people also suffer from osteoporosis?

Osteoporosis can be roughly divided into three types: senile osteoporosis, osteoporosis in postmenopausal women, and osteoporosis caused by special diseases.

Did you know? Many young and middle-aged people are also at high risk of osteoporosis. With the continuous acceleration of urbanization in my country, unhealthy lifestyle is one of the risk factors for osteoporosis. Many young people like to stay at home and lack sunlight. Some young people do not move for a long time, resulting in a decrease in bone mass and disuse osteoporosis.

Osteoporosis is extremely harmful and can cause pain all over the body, mainly in the waist and back, shortening, hunchback, and even serious fractures (spine, hip, wrist, humerus).

October 20 is World Osteoporosis Day, with the theme of "Early Screening of Bone Mass, Early Prevention of Fractures". Osteoporosis should be prevented from a young age. When it comes to osteoporosis, many Chinese people's first reaction is "calcium deficiency", thinking that calcium supplementation will be enough. This idea underestimates the danger of osteoporosis. In fact, taking calcium tablets cannot fundamentally change the problem of osteoporosis.

1. Which six groups of people should be aware of their susceptibility to osteoporosis?

(1) Women over 50 years old and men over 65 years old with unexplained chronic low back pain;

(2) Those with multiple osteoporosis risk factors, such as advanced age, smoking, long-term bed rest, immobilization, etc.;

(3) Women who have undergone bilateral oophorectomy and have undergone natural menopause before the age of 45;

(4) Adults with low sex hormone levels due to various reasons;

(5) Adults with a family history of fragility fractures;

(6) Those with a history of diseases that affect bone metabolism: including rheumatic autoimmune diseases, gastrointestinal diseases, hypogonadism and other endocrine system diseases, blood system diseases, neuromuscular diseases, chronic kidney disease and cardiopulmonary diseases.

2. Beware of drug-induced osteoporosis

In recent years, more and more drugs have been found to cause bone loss and fractures, leading to drug-induced osteoporosis, such as glucocorticoids, anticoagulants, thiazolidinediones hypoglycemic drugs, proton pump inhibitors, antiepileptic drugs, aromatase inhibitors, gonadotropin-releasing hormone analogues and excess thyroid hormone.

During medication, you should pay attention to whether there is gradually worsening low back pain, joint pain or limited movement. Once found, you should seek medical attention in time, adjust the usage and dosage of the medicine, and give drug treatment if necessary.

3. How to diagnose osteoporosis?

(1) Bone density measured by dual-energy X-ray absorptiometry (DXA): It is the currently commonly used diagnostic indicator for osteoporosis.

(2) For postmenopausal women and elderly men, once imaging examinations such as X-rays, CT, MRI and bone scans show clear signs of fragility fractures, osteoporosis and osteoporotic fractures can be diagnosed regardless of whether the bone density results meet the diagnostic criteria for osteoporosis;

(3) Before a brittle fracture occurs, the main basis for diagnosing osteoporosis is bone mineral density (BMD) measurement results.

4. Methods to prevent osteoporosis

(1) Dietary supplementation: Eat a balanced diet rich in calcium, low in salt and moderate in protein. Calcium-rich foods include milk, dried shrimp, kelp, sesame paste, etc. The best sources of vitamin D in food are eggs, fish and fortified milk;

(2) It is recommended to perform regular weight-bearing and muscle-strengthening exercises to reduce the risk of falls and fractures. If osteopenia already exists, calcium supplementation should be actively performed according to the doctor's advice or instructions;

(3) Adjust your lifestyle, quit smoking, limit alcohol consumption, avoid excessive drinking of coffee and carbonated beverages, and try to avoid using drugs that affect bone metabolism;

(4) Increase outdoor exercise and sun exposure. Appropriate ultraviolet radiation can convert provitamin D in the skin into vitamin D, thereby promoting calcium absorption. It is recommended to receive at least 20 minutes of sunlight exposure per day on average.

Note: Sunscreen, parasols, and sunbathing behind glass will affect the synthesis of vitamin D in the body, increasing the risk of osteoporosis. Appropriate activities are beneficial to osteoblast activity and slow down the occurrence of osteoporosis.

5. How to treat osteoporosis?

(1) Basic supplementation for bone health

Calcium and vitamin D are basic medicines for daily prevention and treatment of osteoporosis. The recommended intake for adults is 800 mg of elemental calcium per day, and the recommended intake for women aged 50 and above is 1200 mg per day. The recommended intake of vitamin D3 is 600 IU per day. When used for the prevention and treatment of osteoporosis, the recommended dose is 1000-2000 IU per day.

(2) Drug treatment of osteoporosis

The course of anti-osteoporosis drug treatment should be individualized, all treatments should be continued for at least 1 year, and after the initial 3 to 5 years of treatment, the patient's risk of osteoporotic fractures should be fully assessed.