Osteoporosis is a common bone disease among middle-aged and elderly people and one of the main causes of fractures. Data show that osteoporosis has become an important health problem for people over 50 years old in my country. Therefore, as age increases, bone density measurement has become a recommended additional examination item in physical examinations.
However, osteoporosis is not “exclusive” for the elderly. Young people are also at risk of osteoporosis.
CCTV.com has joined hands with Peking University Third Hospital to launch a series of science popularization series called “Understanding High-Frequency Words for Physical Examination”, which will help you quickly learn all the knowledge about physical examination in one place!
In this episode, a reporter from the “News+” column of CCTV invited Zhang Zhishan, chief physician of the Department of Orthopedics at Peking University Third Hospital, to explain osteoporosis in detail. He said that young people should pay attention to drinking less carbonated drinks and coffee, and change bad habits such as partial eclipse, inactivity, smoking, and alcoholism to prevent and reduce the occurrence of osteoporosis.
What is osteoporosis?
Zhang Zhishan: Osteoporosis is common in people over 50 years old. It is a bone disease characterized by loss of bone strength. It can lead to increased bone fragility, thereby increasing the risk of fractures. Among them, bone strength includes two aspects: bone mass (bone density) and bone quality. If osteoporosis occurs, bones will become sparse from their original “denseness”.
Osteoporosis is divided into three major categories. The first category is primary osteoporosis, which is mainly osteoporosis caused by aging in the elderly and osteoporosis in women after menopause.
The second category is secondary osteoporosis. Secondary osteoporosis can be understood as osteoporosis caused by various causes, such as osteoporosis caused by rheumatology and immunology diseases, endocrine system diseases, etc.
The third type is idiopathic osteoporosis, which is more common in adolescent scoliosis patients or women who are pregnant or breastfeeding. Most of the causes of this type of osteoporosis are genetic factors.
But it should be noted that osteoporosis is a chronic disease, not a disease of old age. Osteoporosis occurs in some younger people, so the disease is not unique to older people. However, if a young person develops osteoporosis, his or her age is an unusual age of onset, and secondary osteoporosis should be ruled out.
What bad habits are related to osteoporosis in young people?
Zhang Zhishan: The causes of osteoporosis in patients are divided into controllable factors and uncontrollable factors. Uncontrollable factors include age, gender, disease, etc., which we cannot change.
Factors we can control include many of our current bad habits. The first is dietary habits. If you drink a lot of carbonated drinks and coffee for a long time, it will increase the risk of osteoporosis. At the same time, if you have the habit of partial eclipse, it will also lead to nutritional imbalance and the possibility of osteoporosis.
Secondly, being inactive or exercising less may also lead to osteoporosis.
Finally, heavy smoking and alcohol abuse will also increase the possibility of osteoporosis.
Therefore, in daily life, we must consciously adjust these bad living habits. These habits are controllable and allow us to prevent or reduce the occurrence of osteoporosis in a timely manner.
In daily life, how to judge whether you are at risk of osteoporosis?
Zhang Zhishan: First of all, we can start with long-term and chronic symptoms. Osteoporosis is a process of slow loss of bone calcium and generally does not cause special symptoms. However, some groups need to pay attention. For example, some women are particularly thin and have a low body mass index, which is a high-risk factor.
Second, if you suffer from thyroid disease, hyperthyroidism, gastrointestinal disease, or some rheumatic and immune diseases, such as ankylosing spondylitis, lupus erythematosus, etc., in order to treat these diseases, the patient takes long-term and large amounts of hormones, which is also a high-risk factor.
Third, because we are always growing, our weight and body shape generally do not change much after we develop into adults. If there is rapid weight gain and body shape changes within six months to one year, be careful about whether there are some diseases in the body.
In addition, when bone mass is lost rapidly, some symptoms may appear, including low back pain, sore limbs, or symptoms similar to lumbar disc herniation and lumbar spinal stenosis.
Back pain and joint pain are very common in daily life. If these symptoms are chronic pain for a long time and do not improve significantly after taking medicine, then you should think about whether there are other reasons for the pain.
In addition, if you have repeated fractures, you should be careful that your body has osteoporosis. There is a rare genetic disease in clinical practice called osteogenesis imperfecta. When it is more severe, patients with this disease will be called “glass men”. Such patients are prone to fractures since childhood and will have some unique symptoms.
We found in previous cases that when a patient in his 20s with a tibial plateau fracture of the knee underwent surgery, it was discovered during the operation that his bone quality was very poor, like a person in his 70s or 80s. After questioning him, he learned that the patient had fractured three times before. Each time, the orthopedic surgeon told him that there was a bone problem, but he did not examine it in detail. After genetic monitoring, it was discovered that he suffered from a rare genetic disease – osteogenesis imperfecta.
How to prevent osteoporosis?
Zhang Zhishan: In fact, bone mass will go through several periods in a person’s life.
The first is the period of rapid growth of bone mass. From childhood to adolescence, bone mass will continue to increase; after adolescence, it will enter the second period – the slow growth period of bone mass; bone mass will stabilize in the third period, generally reaching the bone mass of a person’s lifetime around the age of 35. peak volume.
Bone mass is like saving money in the bank. The more you save before the age of 35, the more bone mass will be retained in the end. After the age of 35, bone mass will enter the fourth period – the slow loss period; the fifth period The first period is the rapid loss period, that is, after women reach menopause, the bone loss rate will increase by 3-5 times; in the sixth period, bone loss tends to be slow again, and bone loss continues until old age.
So what we can do is to increase peak bone mass as much as possible when we are young. We should pay attention to balanced nutrition and active exercise from childhood. At the same time, when bone mass is lost rapidly, measures must be taken to slow down the rate of bone loss.
Nowadays, young people are under great pressure from study and work. Their time for outdoor activities has been significantly reduced, and they receive very little sunshine. Judging from the fracture patients hospitalized in our hospital, the levels of vitamin D in their bodies are all lower than normal.
Therefore, we have always emphasized the need to pay attention to sunlight exposure and supplement vitamin D. If you have few daily outdoor activities and have been working and studying indoors, it is recommended to supplement with some vitamin D3 to enhance calcium absorption, which is very helpful for bone health.