Osteoporosis Essay Example

50-85 percent of the variation in peak bone density, bone size, and hip geometry (Rizzoli, 2010).

Genetics play a significant role in bone turnover and micro-architecture, accounting for variability ranging from 0 to 60 percent (Rizzoli, 2010). Certain single-gene mutations, such as collagen type 1 alpha and alpha 2 mutations, can result in osteogenesis imperfecta, which causes brittle bones (Rizzoli, 2010). Moreover, mutations that deactivate the low-density lipoprotein gene cause pseudoglioma syndrome, while activating mutations are associated with syndromes characterized by high bone mass and strength (Rizzoli, 2010). The different variations in DNA sequences determine an individual's susceptibility to idiopathic osteoporosis and fractures.

The peak bone mass can differ depending on various factors such as heritability, ethnic origin, and body size. Research indicates that African-Americans have a reduced risk of hip fractures because they possess higher mineral density compared to Caucasians (Meunier, 1998). Hormones play a critical role in the development, maintenance, and decline of bone mass in both growing individuals and aging skeletons. Estrogen is crucial for the closure of growth plates in both males and females (Rosen, 1996). As a result, girls who experience delayed menarche tend to have lower bone mass density. Sex steroids contribute to increased bone mass and size in males.

Researchers suggest that the higher prevalence of osteoporosis in women can be attributed to hormonal differences between males and females. As people get older, both estrogen levels in women and testosterone levels in men decrease significantly, resulting in the development of osteoporosis (Rizzoli, 2010). Before reaching menopause, normal estrogen levels aid in reducing bone turnover and preventing negative bone balance. Furthermore, the parathyroid hormone plays a role in regulating bone turnover by

promoting the production of local factors such as IGF-1 (Rosen, 1996). This hormone opposes calcitonin and stimulates osteoclast activity.

Enhancing bone resorption is an important factor in promoting both bone formation and resorption. The growth hormone also plays a role in this process. Crucial minerals like calcium and phosphate are necessary for bone formation. Additionally, the calcitonin hormone helps inhibit osteoclast activation and aids in depositing calcium and phosphate into the bone (Rosen, 1996).

Insufficient supply of minerals can lead to changes in bone formation, which weakens bone tissue and increases the risk of fractures. The proteins, caffeine, and other minerals also have an impact on peak bone mass. Additionally, environmental factors play a significant role in the development and progression of osteoporosis.

There are multiple factors that contribute to the development of osteoporosis, including smoking, alcoholism, and certain medications. Smoking affects bone density by changing serum estrogen levels. Alcohol has a negative impact on osteoblasts and interferes with regular bone remodeling. Additionally, high levels of Glucocorticoids disrupt both bone remodeling and calcium regulation.

Clinical manifestation and diagnosis

Osteoporosis typically does not show symptoms until fractures, spinal deformity, dorsal kyphosis, or cervical lordosis occur (Hoffmann, 2008). The vertebrae of the lower spine, wrist, and femur near the hip joint are most vulnerable due to their honeycomb bone structure which is highly susceptible to falls (Eckman, 2010). Various fractures can cause compression of vertebral bodies. Fractures commonly result from bending, lifting, or minimal stress. Vertebral collapse leads to pain during standing or sudden movements (Aeib et al., 2005).

Spinal fractures lead to height loss and a rounded back. Hip fractures result in disability and increased mortality. Wrist fractures deform and impact daily

activities. Unexplained fractures necessitate determining bone quality and density.

The presence of osteoporosis can be identified by observing certain pathological findings, such as the loss of coarse cancellous bone and thinning of the cortex. Additionally, the trabeculae in the cancellous bone becomes thinner and porous, which significantly raises the risk of fractures. To diagnose these conditions, medical experts rely on tests like DEXAS scanning (Braun & Anderson, 2007).