These factors increase the risk of osteoporosis

MADRID (EUROPA PRESS).- Factors such as age, female sex, hip fracture in parents or having had a previous fragility fracture make up some of the risks of suffering from osteoporosis, as explained by the coordinator of the Working Group of Osteoporosis and Mineral Metabolism (GTOMM) of the Spanish Society of Internal Medicine (SEMI), Dr. Rosa Arboiro.

As the expert has highlighted, within the framework of the XVII Meeting on Osteoporosis and Mineral Metabolism of the SEMI, there are also other factors such as “smoking, alcohol consumption, lack of physical activity, low weight, diseases endocrinological and inflammatory bowel disorders and treatments such as glucocorticoids”.

It is a chronic and progressive pathology that leads to the loss of bone mass and resistance and that has, in Spain, a prevalence rate in the general population of 22.5 percent in women and 6.8 percent in older men. of 50 years, with more than 285 thousand new fractures each year.

PREVALENCE IN PATIENTS WITH COPD

In relation to the complexity of its treatment, Dr. Arboiro has stressed that “in people of a certain age, very common diseases such as diabetes mellitus, high blood pressure, hypercholesterolemia, kidney failure or COPD coexist.”

Precisely, at this year’s event, special emphasis has been placed on osteoporosis in diabetic patients and patients with COPD. In this sense, it is estimated that 80 percent of osteoporotic patients present at least one underlying chronic comorbidity.

Some studies have described, as highlighted by the GTOMM coordinator, a “prevalence of osteoporosis between 24 percent and 44 percent in the population with COPD in several countries around the world.”

Although the etiology of bone mass loss in COPD is unknown, SEMI has suggested that it is probably multifactorial, including female sex, treatment with oral or inhaled corticosteroids, hypogonadism, smoking, lack of physical conditioning, vitamin D deficiency and chronic inflammation.

????#17SEMIOsteoporosis #notadeprensa | “80% of people with osteoporosis have at least one comorbidity that can affect their prognosis and evolution” #SENT #MedicinaInterna @GtoSemi pic.twitter.com/DGUoL0M3jg
— Spanish Society of Internal Medicine (SEMI) (@Sociedad_SEMI) April 30, 2024

HIP FRACTURE, ONE OF THE MOST FREQUENT

As highlighted by Dr. Arbeiro, the direct consequence of osteoporosis “is the increased risk of fractures and the increased incidence of fragility fractures.” Fractures of the hip, vertebra and forearm are the most common and together account for half of all fractures.

“One of the ways in which it affects women after menopause is known as postmenopausal,” stressed the expert, who added that “in men it is usually idiopathic or secondary to a wide number of diseases,” such as certain endocrinopathies, alcoholism, rheumatic diseases, many neoplasms or their treatment, caused by drugs, or secondary to diseases such as strokes or paraplegias or tetraplegias.

During the meeting, the use of non-invasive imaging techniques to measure bone quality and quantity and in clinical research, such as the usefulness of Trabecular Bone Score and 3D-DXA, was also analyzed.

Both techniques are based on the application of a specific computer program in each case to the bone densitometry files, providing information on bone quality and microstructure.

MAIN COMPLICATIONS AND PROGNOSIS

In Spain, of the total fractures that occur, according to the latest available data, 22 percent are hip fractures. According to SEMI, after a fragility fracture in patients with osteoporosis, mortality is almost 15 percent per year. If other consequences of the fracture are added, such as thromboembolism, this mortality rises to almost 20 percent per year.

In the case of hip fracture, despite advances in achieving early surgery and optimal postoperative care, mortality in the first year after a hip fracture is still 20 percent. Specifically, in Spain, the rate is 176.8 hip fractures per 100 thousand inhabitants.

About 70 percent of fractures of this type occur in women and more than 40 percent in people 85 years of age or older. The functional impact is also important, since one year after the hip fracture, 40 percent of patients are still unable to walk on their own, and 80 percent have functional limitations that interfere with the basic activities of their daily life ( ABVD).

NEW OSTEOFORMING TREATMENT

In relation to the treatment of osteoporosis, a new osteoforming treatment has been discussed: abaloparatide. It is a “treatment that has been available in the US and other countries for a few years”, as explained by the expert, and will arrive in Spain soon.

During the meeting, “the differences in the mechanism of action compared to other anabolic agents”, available until now, “their characteristics in terms of safety aspects and effectiveness in reducing the appearance of osteoporotic fractures” were also presented. apostilled by the secretary of the WG on Osteoporosis and Mineral Metabolism (GTOMM) of the SEMI, Dr. María Jesús Moro.

Based on these data, the profile of patients who are proposed as susceptible to treatment has been analyzed, “especially postmenopausal women with a very high risk of fracture, especially vertebral, but possibly given its effect on cortical bone, also in patients with fracture.” hip”, as the expert has indicated.

TRANSLATIONAL MEDICINE AND OSTEOPOROSIS

In another of the tables, translational medicine and osteoporosis were also discussed. Along these lines, “basic aspects of bone biology have been addressed to better understand the mechanisms of certain treatments that improve bone mass.”

Thus, since “the discovery of the PTH/PTHrP receptor, much progress has been made in knowledge, to the point that today we have two drugs capable of inducing its activation and producing relevant osteoanabolic effects for the lives of patients suffering from osteoporosis,” added Dr. Moro.

In this way, it has been addressed “how mechanical loading and drugs, such as Teriparatide and Abaloparatide, act together through the activation of the PTH/PTHrP receptor in the primary cilium of osteocytes, to inhibit bone resorption.” and improve bone mineral density”, concluded the secretary of the SEMI GTOMM.