Osteoporosis
What is osteoporosis?
Osteoporosis is a very common chronic bone disease. When people grow older, there is continuous loss of calcium from the bone. Bone becomes weaker and thinner when the loss of bone is greater than new bone formation. When this condition becomes more severe, there will be bone deformity and even fracture. Bone mass starts to decrease after the age of 35 in both sexes. However, in women there is exacerbated bone loss due to estrogen deficiency after menopause. Thus, the incidence of osteoporosis is higher in women. It is estimated that there are about 200,000 people in Hong Kong suffered from osteoporosis. Most of them, about 70%, are women. More and more women are expected to suffer from this disease as women・s life expectancy increase in Hong Kong.

The consequences of osteoporosis

Osteoporosis is a ．silent disease・ at its early stage. Severe osteoporosis leads to bone deformity and fracture. Fractures commonly occur at the forearm, spine and hip. Hip fracture has the most serious consequence among these fractures. There is a 50% chance that the woman becomes bed-ridden after hip fracture.

How to prevent osteoporosis?

Prevention should start when the woman is young. There should be adequate intake of calcium and vitamin D. Weight bearing exercise eg. Jogging and walking can prevent bone loss. Smoking, alcohol consumption, excessive coffee and tea should be avoided. Women who have early menopause before 45 years old can consult their doctor for the need of specific preventive measures.

How do I know if I have osteoporosis?

Clinical research has shown that bone density is related to fracture. We can measure the bone density to diagnose osteoporosis and assess the risk of fracture. Dual energy X-ray Absorptiometry (DEXA) is currently the most reliable method of measuring bone density. This machine uses X-ray to measure bone density and the amount of radiation used is less than an ordinary chest X-ray. Therefore, it is a very safe investigation. The person just has to lie down and the machine will measure the bone density at the hip and spine. The test just lasts for 20 minutes.

Who need to have bone density measurement?

Since osteoporosis is related to age, it is advisable that all women above 65 should have assessment for the risk of osteoporosis. Postmenopausal woman (usually above 50 years old) who has one of the following risk factors should also be assessed:

1.Personal history of fracture
2.Osteoporotic fracture in the first-degree relative
3.BMI <20 kg/m2 or body weight less that 100 lb
4.Smoking and drinking habit
5.Dowager・s hump or loss of height
6.Menopause before the age of 45
7.No period for more than 1 year before menopause
8.Surgical removal of ovaries before menopause
9.Lack of calcium in the diet
10.Excess intake of caffeine (more than 4 cups of coffee, 6 cups of tea or 8 cans of coke)
11.Lack of exercise
12.Taking steroid for more than 3 months in the past

You can consult your doctor if you have any queries about your risk of having osteoporosis. The staffs in the Women・s Diagnostic and Treatment Centre in Tsan Yuk Hospital would also be happy to answer your questions.

 
DEXA scan