Osteoporosis
Hsin-Jou Wang
(Physician, Family Medicine of NCKU Hospital)
Human skeleton development requires sufficient vitamin D and calcium with appropriate weight-bearing exercises (such as running, weight training, skipping rope) to stimulate bone growth. Bone density decrease and osteoporosis will take place more likely when one experiences calcium deficiency, lack of activity, or chronic inflammation for a long time. The diagnostic conditions for osteoporosis are as follows:
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For postmenopausal women or men over 50 years of age, the T value of DXA (bone density test) is suitable for diagnosis. Osteoporosis is diagnosed when the T values ≦ -2.5, whereas low bone mass is diagnosed when we have a T value between -1 and -2.5.
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For younger patients, the Z value of DXA is applicable. Z value equal to or less than -2.0 is lower than the expected value of the same age, but cannot be diagnosed as osteoporosis.
Prevention of fractures is also the main goal of osteoporosis treatment. Osteoporotic fractures often occur in the spine, hips, wrists, etc. under low impact energy (lifting weights, running, falling, pulling, etc.).
Since the symptoms of vertebral fractures are relatively imperceptible, it is recommended to regularly screen the spine for abnormalities in X-rays. Many medical studies have shown that EB patients, especially the more severe subtypes such as RDEB (recessive dystrophy) and JEB (joint type), are high-risk groups for osteoporosis. Studies have also pointed out that insufficient activity is the biggest factor leading to osteoporosis. Therefore, patients are recommended to exercise as much as possible and supplement sufficient calcium and vitamin D. Taking bone mineral density checks and spine X-rays at one’s expense regularly is also suggested.
Reference:
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Martinez AE, Mellerio JE. Osteopenia and Osteoporosis in Epidermolysis Bullosa. Dermatologic Clinics. 2010;28(2):353-355. doi:10.1016/j.det.2010.01.006
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Consensus and Guidelines for the Prevention and Treatment of Adult Osteoporosis in Taiwan
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The book of “Diagnosis, treatment and care of osteoporosis & sarcopenia” by Dr. Dai Dawei.