Osteoporosis
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Transcript of Osteoporosis
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OsteoporosisOsteoporosisSlide showSlide show
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The Osteoporosis LandscapeThe Osteoporosis Landscape
In India, an estimated 43 million women suffer from osteoporosis
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India: Some Hard Facts India: Some Hard Facts Over 61 Million Indians have
osteoporosis.
80% are women.
On a global basis, Indians have the highest prevalence of osteopenia.
Compared to Caucasians, osteoporotic fractures in the Indian population occur 10-12 years earlier in age.
Osteoporotic fractures are more common in Indian men than in the West.
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India: Some more hard factsIndia: Some more hard facts
Over 45 Lakhs Indian women above 60 have a fractured spine.
Over 2.5 Lakhs Indians suffer osteoporotic hip fractures every year.
Most of these fractures are never investigated for osteoporosis - and therefore never treated for the cause.
Gupta et al, Indian Journal of Medical Research 1967:55:1341-8
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Incidence of Hip fracturesIncidence of Hip fractures
Asia will emerge as the largest sufferer of osteoporosis related
fractures
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Osteoporosis vs other Osteoporosis vs other diseasesdiseases
Total incidence of osteoporosis related fractures far exceeds other
diseases
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What makes us more prone?What makes us more prone? Indians have a poor calcium intake
– We don’t drink enough milk as children– We have a higher incidence of varied degrees of lactose intolerance– Rice is a poor source of calcium– Vegetarian diets and cereals have low bio-availability of calcium
(<30%)
Vit D deficiency is common
Protein intake is poor
Excess salt intake – may increase urinary loss of calcium
Healthy exercise is neglected
Significantly lower BMD: mean spinal BMD by DEXA is 2SD below the American-European population between 20 to 59 yrs population*
Lower BMI: osteoporosis is more common in thin women
Late menarche’ in girls - low estrogen exposure
Awareness is low*Nangia et al, ESICON 1977
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Why is osteoporosis serious?Why is osteoporosis serious?
It affects many more women than heart attacks, strokes and breast cancer together
Osteoporosis kills by its complications-An osteoporotic fracture reduces the sufferer’s life expectancy by a decade.
In addition, it seriously compromises quality of life
Fractures are very expensive to treat-the economic burden of osteoporotic fractures is immense.
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Common Fracture/BMD Common Fracture/BMD measurement Sitesmeasurement Sites
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World Health Organization (WHO)World Health Organization (WHO)
guidelines for osteoporosisguidelines for osteoporosis
Osteoporosis Osteopenia
Normal
Peak Bone Mass
-2.5 -2 0T-Score -1
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Who to Treat?Who to Treat?
Therapy Decision
High Risk
Treat
Moderate Risk
Treat if other risk factors
Low Risk
Check again in 1-2 years
T-Score*
Below -2.5
-1.0 to -2.5
Above -1.0
International Osteoporosis Foundation. 1998.
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Osteoporosis: a team work
Patient & Family
Dietitian
Physio.
Govt.NGO
Sp. Doctor
OrthotistFm. Doctor
Sp. NurseOrthopaedic
Surgeon