She has had chest pain for two weeks.
"Two weeks ago, I accidentally hit the table at home, which was quite heavy. It hurts now. I thought it was a soft tissue contusion, and I put on a few plasters myself, which didn't improve at all. "
Cough and breathe in the left chest, and you can't lie to the left when you sleep. She couldn't stand it, so she came to see the doctor.
In the outpatient clinic, Director Li found that there was a local tenderness point, so he took a chest rib positive radiograph, showing that 6-8 ribs on the left side were fractured, and the bone density was measured, -2.6.
Explain here that a BMD value above-1 is normal bone mass, -2.5- 1 is osteopenia, below -2.5 is osteoporosis, and below -2.5 is complicated with brittle fracture, that is, severe osteoporosis.
"I broke three ribs when I hit the table?"
"Some patients with severe osteoporosis whose bone density is below -4 have broken their ribs with a few coughs. Your bone mineral density level is not very low, but it is already in the category of severe osteoporosis. "
Took diet pills for two years.
Body mass index decreased to 15.
"Osteoporosis is not a geriatric disease? Moreover, no one in my family has osteoporosis, and my mother has never broken a bone in menopause for several years. "
Director Li looked at Ms. Hu. She is slim, or rather, a little too thin.
"How much do you weigh?"
"After I gave birth to a child, I lost weight for two consecutive years. Now I weigh 76 kg and my height is 165cm. " Ms. Hu feels that she has lost weight successfully. She admits that she mainly relies on diet control and taking diet pills, and doesn't exercise much.
In the past two years, she has been adhering to a low-fat and low-carbon water diet, without extra calcium supplementation. Body mass index (BMI = weight/height squared, international unit kg/m 2) has dropped from 25 after birth 15 to now.
"Do you have any other pain symptoms besides chest pain after hitting the table?" Osteoporosis patients may have "micro-fractures" in other parts of the body, resulting in painful symptoms.
"Other parts don't hurt." However, Ms. Hu recalled that she had symptoms of leg cramps in the last three months, about once every three to five days.
"Leg cramps are a sign of calcium deficiency in the blood, indicating that your calcium intake is insufficient. This is a warning signal from the body."
Low weight
It is one of the high risk factors of osteoporosis.
Director Li told Ms. Hu that there are probably three reasons for osteoporosis at her age-
First of all, low weight itself will lead to osteoporosis, because bones are gravity-sensing organs, and the pressure load of weight will stimulate bone formation, and losing weight may lead to bone loss;
Second, not much exercise during weight loss and bad eating habits will also cause problems in gastrointestinal health. Malnutrition will further accelerate the reduction of muscle mass and further aggravate osteoporosis;
The last possible reason is that some components of diet pills may also interfere with bone metabolism. For example, orlistat, a common component of diet pills acting on the gastrointestinal tract, will prevent the absorption of dietary fat and affect the absorption of fat-soluble vitamins. Long-term medication will lead to abnormal absorption of vitamin D and osteoporosis.
"Low-weight people are one of the high-risk groups of osteoporosis. Of course, it doesn't mean that the heavier the weight, the better for the bones. Keep your weight in a suitable range. Please refer to the ideal body mass index value 18.5-23.9. "
In addition to bone healing treatment, director Li asked Ms. Hu to carry out nutritional intervention to improve bone mass, otherwise it is very likely to fracture again.
A woman of 35 years old
It should be at the peak of bone mineral density
"At the age of 35, it should have been the highest bone density in a woman's life."
Director Li said that young people have low bone mass, and most patients with osteoporosis are "created" by long-term bad living habits.
"From birth to 35 years old, women's bone mineral density has been rising until the peak, and then from 35 to menopause (about 50 years old), bone mineral density has been declining, and after menopause, it will enter a stage of rapid bone loss. Therefore, postmenopausal women must take extra calcium and vitamin D dietary supplements because their daily average demand is twice that of young people. "
The peak age of male bone mineral density is around 40 years old, and the rapid bone loss generally begins at 70 years old.
"This is why in most people's minds, osteoporosis is a geriatric disease. Excluding pathological secondary factors, osteoporosis is indeed a physiological degenerative disease that will inevitably occur with age, mainly postmenopausal osteoporosis (type I) and senile osteoporosis (type II)-but now unhealthy living habits are leading to more and more people with low bone mass. Young and middle-aged people should also pay attention to the prevention and treatment of osteoporosis. "
There are a large number of people with low bone mass in China.
One third of people over the age of 40 have insufficient bone mass.
One in every two people over 50 has low bone mass.
Last year, the National Health and Wellness Committee publicly released the first epidemiological survey of osteoporosis in China: the prevalence rate of osteoporosis in people aged 40-49 was 3.2%, that in people over 50 was 19.2%, and that in people over 65 was 32.0%;
Among people without osteoporosis, the low bone mass rate of people aged 40-49 is 34.0%, and the low bone mass rate of people over 50 is 57.4%.
"There are a large number of people with low bone mass and they are potential high-risk groups for osteoporosis."
Director Yan, chief physician of the Department of Orthopaedics, Second Hospital of Zhejiang University, member of the Standing Committee of Osteology Branch of Chinese Medical Association and member of the Standing Committee of Osteoporosis and Bone Mineral Salt Disease Branch of Chinese Medical Association, said that the so-called low bone mass, that is, the bone density is-1 to-2.5; Osteoporosis means that the bone mineral density is below -2.5.
"This is an artificially set standard to evaluate the gap between individuals and their peers in the average bone mineral density level. Those with low bone mass will further lose bone and reach the range of osteoporosis. Therefore, if this group of people combine the following factors, such as long-term drinking and low weight (body mass index)
Do you belong to the high-risk group of osteoporosis?
-accept this one-minute self-test question.
If your answer to a question is yes,
It is recommended to detect bone mineral density.
The following questions are recommended by the International Osteoporosis Foundation (IOF), which can help people at high risk of osteoporosis to self-evaluate-
1. Have any parents been diagnosed with osteoporosis or fracture after a minor fall?
2. Does one of the parents have a hunchback?
Over 3.60 years old?
4. Have you ever broken a bone because of a fall as an adult?
5. Do you often fall (more than once last year), or are you worried about falling because you are weak?
Have you lost more than 3 cm in height after 6.40 years old?
7. Are you underweight? (Body mass index value is lower than 18.5kg/m2)
8. Have you ever taken steroid pills (such as cortisone and prednisone) for more than 3 months? Steroids are usually used to treat asthma, rheumatoid arthritis and some inflammatory diseases.
9. Have you been diagnosed with rheumatoid arthritis?
10. Have you been diagnosed with hyperthyroidism, hyperparathyroidism, type I diabetes or nutritional/gastrointestinal diseases such as Crohn's disease or celiac disease?
1 1. Do you often drink more than the safe amount of alcoholic beverages (more than about 500ml of beer every day/160ml of wine/50ml of spirits)?
12. Have you smoked now or ever?
13. Do you exercise less than 30 minutes every day? (including doing housework, walking, running, etc. )
14. Did you avoid or be allergic to dairy products without taking any calcium supplements?
15. Do you spend less than 10 minutes in outdoor activities every day (exposing part of your body to the sun) and don't take vitamin D supplements?
Madam, please continue to answer the following questions:
16. Have you stopped menstruating at or before the age of 45?
17. Have you ever stopped menstruating for more than 12 months except pregnancy, menopause or hysterectomy?
18. Have you ever had your ovaries removed before the age of 50 and never received hormone replacement therapy?
Please continue to answer the following questions:
19. Have you ever experienced symptoms such as impotence and loss of libido due to low testosterone?
"As long as the answer to any of the above questions is' yes', it means that you belong to the high-risk group of osteoporosis. You can go to the hospital for dual-energy X-ray bone mineral density examination to determine what level of bone mass you are at present."