[Osteoporosis; diagnosis and treatment]

ABSTRACT

Osteoporosis is the most common metabolic disorder which is increasing all over the world. It is associated with age and sex, therefore the highest prevalence of the disease is seen in post menopausal women. Increase in life expectancy and number of old people will cause significant rise in the prevalence of osteoporosis in future. In our country according to Tehran survey, prevalence of osteoporosis in 60-69 yr. women in spine and hip region is 52.4% and 5.9% and in the same age range in men is 9.4% and 3.1%, respectively. Osteoporosis is thus a problem of the world in second half of the present century specially in Asia, so prevention, diagnosis and treatment of disease is imperative for health improvement. One of the most important complications of osteoporosis is fracture of spine and femur neck which increases mortality and morbidity. More than 90% of hip and femur neck fractures occur in 50 yr old or above, and 80% of them are women. Osteoporotic fractures incur high cost for the patient and community. Major risk factors of osteoporosis are age, low bone density, history of fragility fracture and history of familial osteoporosis. Today the diagnosis of osteoporosis is based on bone density measurement. Osteoporosis is a mulitfactorial disorder and its prevention and treatment are difficult. Most of the treatments available for treatment of osteoporosis recent have antiresorptive effects which reduce bone distruction. Some of these drugs also decrease pathologic fractures. New drugs increasing bone formation are coming up. However in all kinds of treatments existance of sufficient calcium and vitamin D reserve is necessary for efficacy of medications that could be provided by nutrition or supplements