The silent enemy

In a recent article published in Osteoporosis International (1), members of the Belgian Bone Club, including Professor Jean-Yves Reginster and Olivier Bruyère, of the University of Liège, explain the current situation and provide a consensus solution for non-pharmacological management of osteoporosis. This presented an opportunity to describe this disease which constitutes a major health problem in all the developed countries.

Osteoporosis and its consequences, the bone fractures which result from it, are not only extremely frequent, but are also growing steadily due to ageing and bad nutrition habits among our populations. “We believe that a hip fracture due to osteoporosis occurs every 30 seconds in the European Union”, explains professor Jean-Yves Reginster, head of the Bone and Cartilage Metabolism Research Unit at the University of Liège (ULg) and President of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

Osteoporosis is a disease that predominantly affects women, due to the drop in oestrogen levels during menopause. In men, androgens play the same protective role for the skeleton that oestrogen does in women, but the androgens become exhausted later, from around the age of seventy.

Osteoporosis is characterized by a depletion of calcium in the bones. This leads to a reduction in bone mass and, at the same time, a change in its structure. “The bone trabeculae which ensure its rigidity and its biomechanical resistance become perforated, causing it to become fragile” explains Jean-Yves Reginster. This results in the possibility of fractures, the three main ones affecting the vertebral column, the wrist (more precisely, the lower extremity of the radius), and the hip. The first usually occurs from the age of around 55-60 in women and 10 to 15 years later for men, so that it generally affects four times more women than men. Named the Colles fracture, the fracture of the lower extremity of the radius is seven times more frequent in women -which it affects more often after the age of 60- than in men. It is typical in a person who falls on a pavement, for example, and lands on his or her forearm.

Osteoporotic fractures

The sadly notorious hip fracture generally occurs later, around the age of seventy-five to eighty. Here, men are also less affected than women: the epidemiological data teaches us that the ratio is three women to two men. “Notwithstanding the advances linked with hip replacements, we see a sixteen to twenty percent death rate in the month following a hip fracture because of complications during operation. We are, in addition, faced with a pathology which causes serious after-effects: among those patients who don’t die from it, only one in three will regain full autonomy of movement. The cost is also gigantic, as high as 54 billion dollars per year for Europe and the United States” laments Professor Reginster.

(1) Non-pharmacological management of osteoporosis: a consensus of the Belgian Bone Club

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