Osteoporosis Flashcards
Is osteoporosis common?
Yes
What proportion of women over 50 will sustain an osteoporotic fracture in their lifetime?
1/3
What % of people with a hip fracture die within a year?
33%
What % of people will require help to walk 1 year after a hip fracture?
35%
How much do hip fracture cost the NHS per year?
£2 billion
How many hip fractures are there per year?
75,000
What is osteoporosis defined as?
Progressive loss of bone mass associated with changes in bone micro-architecture
What pathological process is osteoporosis linked with?
Reduced cross-linking within the trabecular bone, resulting in cortical thinning
What is remodelling?
The normal process continually taking place within bone
Why is bone remodelling an essential process?
Because it allows bone to adapt to stressors and repair microdamage
What is bone remodelling the net product of?
Bone formation and resorption
What is involved in bone remodelling?
- Activation of osteoclasts from circulating precursor-cells
- Aggregation and adherence of osteoclasts to regions of active bone reabsorption on the trabecular plate
- Osteoclastic breakdown of bone matrix
- Simultaneous osteoblastic deposition of osteoid with subsequent mineralisation
What mediates the activation of osteoclasts from circulating precursor cells in bone remodelling?
Receptor binding of NF-kappaB (RANK) ligand
What does the osteclastic breakdown of the bone matrix release in bone remodelling?
- Calcium
- Minerals
- Active growth factors
What causes mineralisation of newly deposited osteoid in remodelling?
Calcium and phosphate deposition
What happens to the remodelling process in post-menopausal women?
There is a shift towards bone resorption, leading to net bone loss
What happen to the function of osteoclasts in postmenopausal women?
They function in a less regulated manner
What is the result of the osteoclasts functioning in a less regulated manner in postmenopausal women?
They perforate through the trabecular plate
What is the result of osteoclasts perforating through the trabecular plate in post-menopausal women?
There is no framework for osteoblast activity and structural integrity is lost
What are the risk factors for primary osteoporosis?
- Female gender
- Previous fragility fracture
- Maternal history of hip fracture
- Current smoker
- Alcohol intake >3 units/day
- Glucocorticoids >3 months at more than 5mg/day
- Low calcium and vitamin D deficiency
- Low BMI