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Mingjie YANG, Orthopedic surgeon
Associate Chief Physician

Have you ever worried about osteoporosis and aging? How can you prevent osteoporosis? Do you have any misunderstanding about osteoporosis?

We will tackle these questions one by one in this article. In terms of osteoporosis, there is actually “inequality” between men and women. For both men and women, their bone mass peaks when they are around 25 years old, and starts declining gradually thereafter. While the decline curve is relatively stable for men, in women there is a sharp decrease in the amount of bone mass which begins with the onset of menopause. A reduction in estrogen protection may lead to climacteric syndrome and a higher incidence of osteoporosis.

Who is more likely to develop osteoporosis?

The average rate of osteoporosis is 13%, but women account for 32%, five times that of men. The majority of bone fracture patients are females over the age of 50, therefore it is important for these women to increase their calcium intake. Women who are slim in build have a higher probability of developing osteoporosis as their estrogen loss occurs earlier on average.

How can we best achieve proper calcium levels?

There are three aspects to balance when it comes to calcium levels in the human body.

The first is the balance of intake and loss, while the other two are the balance of calcium between the blood and bones, and the third is calcium within the bones. Getting some sun, drinking milk, and taking vitamin D, will all help prevent the loss of calcium. If these efforts fail, calcitonin can be applied in high conversion osteoporosis patients and has proven very effective in relieving pain. The third balance concerns osteoclastic and osteogenic systems. Bisphosphonates will be used, however, this treatment won’t be used in those with hypocalcemia. Bone mass keeps remodeling all the time and the balance depends on osteoblast, or bone-resorbing cells, and osteoclast, or bone-forming cells. Estrogen intake can help calcium supplementation to some extent. Teriparatide is the only drug listed by the FDA that has the effect of stimulating bone-forming cells and curbing bone-resorbing cells.

How can we diagnose osteoporosis?

In the past, ultrasonic tests were widely used, but the results were not especially accurate. This method was gradually replaced by dual energy X-ray bone mineral density examination and the use of CT scan. Fractures of the vertebral body can be hidden and difficult to detect, many people don’t even feel pain when walking. It can easily go undetected by but it can lead to the development of a hunched back. More than 50 percent of women over 85 suffer from vertebral fracture.

Any other tips?

Exercise is of great significance. Although the trend of bone mass loss is inevitable, exercise during younger years will lead to a higher peak of bone mass than those don’t exercise.

Are there any common misunderstandings?

Excessive calcium intake will not lead to renal calculus or cholelithiasis in most cases because they regard different areas, namely the alimentary canal and the blood system.

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