Osteoporosis is a disease of the bones, which makes them more fragile and prone to fractures. In a person suffering from osteoporosis, the bone tissue is thin and the bone mass is less than normal. Within certain limits, in the elderly this loss of bone tissue is a normal phenomenon, which accompanies the aging process. However, there are numerous factors that can accelerate the onset of osteoporosis; for example, it is known that a critical moment for women is represented by the entry into menopause. Also for this reason, on average the female sex is affected by osteoporosis 4 times more than the male one. An important characteristic of osteoporosis is that it is a “silent disease”. The silent adjective is intended to underline the general absence of symptoms, at least in the early stages. In fact, initially, bone loss does not cause symptoms or disturbances to the patient, who often notices the problem only after fractures caused by bone fragility. Hip, femur, wrist and vertebrae are the sites most prone to osteoporotic fractures. For this reason it is important to periodically check the health of your bones, through targeted diagnostic tests, such as Computerized Bone Mineralometry. As we will see better in the next video, in fact, osteoporosis can be prevented and treated; therefore, thanks to an early diagnosis and an appropriate treatment it is possible to slow down its progression and reduce the risk of incurring a fracture.
To understand what happens in a bone affected by osteoporosis, it is first necessary to remember some aspects relating to the anatomy and function of the skeletal system. The skeleton, which represents the scaffolding of our body, is made up of bones and cartilage tissue. This skeletal structure performs multiple functions, for example it supports the body, interacts with the muscular system allowing movement and protects vital organs such as the brain, spinal cord, heart and lungs. In addition, the bones represent a reserve of mineral salts, in particular calcium and phosphorus, and other substances, which the body draws on in particular pathological conditions or food deficiencies. From what you may have understood, bone is a somewhat special fabric. The basic organization of the bone tissue is made up of about one third of organic substance and two thirds of inorganic substance, therefore of mineral salts. The organic component forms a kind of framework made up of proteins of various types, such as collagen, which give elasticity and cohesion to the bones. The inorganic component, made up mostly of hydroxyapatite, instead gives hardness and resistance to the skeleton. This particular structure gives the bone truly exceptional properties. The result is, in fact, a sturdy structure, endowed with considerable mechanical resistance, but at the same time elastic and flexible.
Contrary to what many believe, even bone is a "living" tissue of our body. Just think, for example, of the changes it undergoes during growth and development, or the fact that the skeleton is completely renewed every 8-10 years. The bone tissue, in fact, is subjected to a continuous process of renewal, which lasts a lifetime. This process, called bone remodeling, occurs through particular mechanisms of destruction and reconstruction, operated by specialized cells called osteoblasts and osteoclasts. Both of these cells work incessantly to control and maintain the right level of bone mineralization, but they do so with opposite mechanisms. The osteoclasts, in fact, demolish small areas of old or damaged bone, while the osteoblasts rebuild the new structural parts of the bone, filling the microscopic gaps left by the osteoclasts. So, in summary, osteoclasts destroy, while osteoblasts build, working in equilibrium with each other. Over the course of life, however, conditions may arise in which the amount of bone reabsorbed by osteoclasts is greater than that produced by osteoblasts. In practice, the amount of newly formed bone is insufficient to replace the one demolished during the resorption phase. If this imbalance persists for a long time, the bone tissue is depleted and osteoporosis arises.
We have already said that the main complication of osteoporosis is represented by fractures. The bone tissue, becoming more fragile, cannot withstand the normal physiological stresses. The bones, therefore, can fracture even for trivial trauma, if not spontaneously. Not only. Bone thinning and fragility also predispose to alterations in skeletal architecture. This means that, for example, deviations or crushing of the spine can appear, which can be accompanied by pain, such as back pain, and difficulty in standing. In osteoporosis, the reduction in bone mass can be generalized and therefore involve the entire skeleton, or affect only or especially some bone segments. Osteoporosis most frequently affects the spine and long bones, the pelvis and other sites, causing fractures especially affecting the vertebrae, femur, wrist and humerus.
In addition to senile osteoporosis, therefore linked to aging, the disease can exist in different forms. In this regard, a simple classification consists in dividing primary osteoporosis from secondary ones. Primary osteoporosis includes the post-menopausal form, therefore after menopause, and the senile one. Secondary osteoporosis, on the other hand, derives from other medical conditions or from the protracted use of certain drugs, capable of contributing to the loss of bone mass. Now let's see the most common forms of osteoporosis in a little more detail. Postmenopausal osteoporosis is linked to the natural decline in estrogen, which occurs precisely in menopause. These sex hormones, in fact, are also necessary for normal bone metabolism, so their deficiency predisposes to osteoporosis. It is therefore not surprising that women who enter menopause early, therefore before the age of 40, are more exposed to the danger of osteoporosis. . Dell "senile osteoporosis, however, we have already spoken by saying that it occurs at an advanced age, after 65-70 years. It affects both sexes, but as we have just seen it prefers the female one. Within certain limits it also represents a physiological process, as even the bone tissue is destined to age, and with the passing of the years it undergoes a progressive quantitative and qualitative reduction. Turning to secondary osteoporosis, this is often the result of prolonged medical therapies that involve the intake of corticosteroids, then of cortisone and derivatives. Other drugs, such as anti-epileptics, immunosuppressants and thyroid hormones, may also promote osteoporotic problems. Among the pathologies that can favor the onset of osteoporosis, we should first of all mention some endocrine diseases, such as Cushing's disease, hyperthyroidism and hypogonadism. However, some diseases of the gastrointestinal system, such as malabsorption syndromes, celiac disease and Crohn's disease, can however impoverish bone tissue. Furthermore, it should be remembered that osteoporosis can also occur in the case of prolonged immobilization, for example after a fracture, in the presence of calcium deficiency, chronic obstructive diseases of the bronchi and lungs, multiple myeloma, rheumatoid arthritis or some neoplasms. malignant. Last but not least, the role of lifestyle, which can heavily influence the risk of developing osteoporosis. For example, a low-calcium diet and a sedentary lifestyle favor bone weakness. Other factors that increase the possibility of development of osteoporosis are genetic predisposition, excessive thinness, alcohol abuse and cigarette smoking.
