Osteoporosis is a disease that reduces mass and density of bones, and thus, makes them fragile and increases their susceptibility to fracture. When the rate of bone formation is lower than the rate of bone resorption, the mass and density of bones reduce. Under normal circumstances, bone resorption and bone formation are processes that are involved in the growth and development of bones. Given that bone is a living tissue, it has cells called osteoblasts and osteoclasts, which are responsible for bone formation and bone resorption respectively. Sunyecz (2008) states that osteoporosis occurs when estrogen level decreases and the rate of bone resorption increases among postmenopausal women. In this case, decreased level of estrogen is the prime cause of osteoporosis. Usually, primary osteoporosis commences during menopausal period, while secondary (senile) osteoporosis starts at the age of 75. Primary osteoporosis affects women because of the hormonal changes that occur in their bodies. Hence, the occurrence of osteoporosis in this case implies that bone resorption has considerably reduced bone mineral density. In this view, the study of bone mineral density is significant because it shows the activity of osteoclasts, strength of bones, and susceptibility of bones to fracture.
T scores are very significance in the study of bone mineral density because they are numerical parameters, which measure the degree of osteoporosis. The diagnosis of osteoporosis using dual-energy X-ray absorptiometry, which World Health Organization recognizes it as a gold standard, generates T scores. Fundamentally, T scores are standard deviations, which emanate from the comparison of the bone mineral density of a given person to that of a healthy young person (30-40 years). The significance of T scores is that they show the extent in which bone mineral densities of patients with osteoporosis are below that of a young healthy person. Moreover, T scores are significant in staging osteoporosis. According to Sanders and Geraci (2013), T scores show that a normal person has values that are > -1, a person with osteopenia has values that are ≤ -1 and ≥ -2.5, a person with osteoporosis has values that are ≤ -2.5, and a person with severe osteoporosis has values that are ≤ -2.5 and exhibits some fractures. In this case, the osteoporosis has T scores that are less than or equal to -2.5, which implies that the bone mineral density of the patient is 2.5 or more standard deviation below that of a normal person.
Risk factors for osteoporosis are age, gender, lifestyles, medical disorders, and medications. The occurrence of osteoporosis increases with age because bone formation declines with age. Regarding the risk factor of gender, females are more prone to osteoporosis than males because of the hormonal changes, for instance, a decline in the levels of estrogen and an increase in the levels of parathyroid hormone. Lifestyle habits such as excessive consumption of alcohol coupled with smoking and consumption of caffeine accelerate resorption of radial and femoral bones (Sanders & Geraci, 2013). Additionally, lifestyles that lead to deficiencies in vitamin D and calcium, malnutrition, high dietary protein, and lack of adequate exercise increase the risk of osteoporosis. Medical disorders such as cystic fibrosis, hyperthyroidism, Cushing’s syndrome, and Parkinson’s disease amongst others increase the risk of osteoporosis. Glucocorticoids, barbiturates, proton pump inhibitors, and thiazolidinediones are some of the medications that predispose people to osteoporosis.
Current treatments used in the management of osteoporosis among women include combined hormone therapy, calcium and vitamin D supplementation, pharmacological intervention, and mitigation of risk factors. According to Sanders and Geraci (2013), estrogen-progestin is a combined therapy that reduces the rate of bone resorption, which normally increases during and after menopause. Sunyecz (2008) argues that calcium and vitamin D therapy are effective in the prevention and management of osteoporosis for they provide nutrients that are essential in bone formation. In the aspect of pharmacological intervention, raloxifene, bisphosphonates, denosumab, calcitonin, and parathyroid hormone are some of the approved medications. Avoidance of excess alcohol, smoking, malnutrition, predisposing medications, and exercising appropriately are necessary measures of mitigating the risks of osteoporosis.
References
Sanders, S., & Geraci, S. (2013). Osteoporosis in postmenopausal women: Considerations in prevention and treatment. Southern Medical Journal, 106(12), 698-706.
Sunyecz, J. (2008). The use of calcium and vitamin D in the management of osteoporosis. Therapeutics and Clinical Risk Management, 4(4), 827-836.