你的身体会定期更换骨骼的组成部分. When those components are lost too rapidly or not replenished quickly enough (or both), 骨质疏松症的发生. 骨质疏松症影响着1000多万美国人. While women are at higher risk for the disease, men can develop it, too. 研究表明，在50岁及以上的人群中:

• Up to 1 in 2 women will break a bone due to osteoporosis — equal to the risk of breast, 卵巢癌和子宫癌合并.

• Up to 1 in 4 men will break a bone due to osteoporosis — a risk greater than prostate cancer.

幸运的是，骨质疏松症是可以预防的. When it does occur, your doctor can diagnose and treat it before it causes a broken bone. Even after a fracture, further problems are avoidable with the right steps.

骨质疏松症有哪些症状?

Osteoporosis is often called the silent disease because it may not cause symptoms. 一些患者经历:

• Broken bones (mainly hips, spine or wrists), even from minor falls or bumps

• Collapsed vertebrae — leading to severe pain, a decrease in height or a spine deformity

Such symptoms can also come from other bone disorders or medical problems. 一定要向医生咨询诊断.

骨质疏松症的危险因素是什么?

Several factors appear to increase the risk of developing the disease:

• Age. 50岁以后风险增加

• Gender. 女性患骨质疏松症的可能性是男性的4倍

• Race. The disease can affect anyone, but white and Asian women are most at risk.

• Menopause. 雌激素缺乏会导致骨质流失

• 骨质疏松或骨折家族史

• 体重低或瘦小的

• 没有摄入足够的钙和维生素D

• Not eating enough fruits and vegetables for other nutrients (magnesium, potassium, vitamins C and K)

• 没有摄入足够的蛋白质

• 摄入过多的酒精、钠或咖啡因

• 不运动的生活方式

• Smoking

某些药物(如强的松).g.) and diseases can also cause bone loss and increase the risk of osteoporosis.

如何预防骨质疏松症?

To protect their skeleton, men and women of all ages should ensure they are:

• 摄入足量的钙和维生素D

• Following national nutritional guidelines for protein, fruit and vegetable intakes.

• 增加负重活动

• 将酒精摄入量限制在适度或更少

• 如果你吸烟，请停止吸烟

If you’re a woman who has gone through menopause or a man older than age 50, your doctor should follow National Osteoporosis Foundation guidelines and:

• 告诉你你患骨质疏松症和相关骨折的风险

• Recommend a diet rich in fruits and vegetables that includes adequate vitamin D and calcium, 必要时服用补品

• 建议定期进行负重和肌肉强化锻炼

• 评估跌倒风险并提供适当的预防措施

• 问问自己是否吸烟，喝多少酒

• 每年测量你的身高

骨质疏松症的诊断

A 骨密度测试 (also called bone densitometry or DXA) involves a special X-ray machine and is the only way for doctors to determine whether you have osteoporosis. 这种扫描建议用于:

• 所有65岁及以上的女性

• 所有70岁及以上的男性

• 某些绝经后妇女，取决于危险因素

• 某些男性年龄在50-69岁之间，取决于风险因素

• Certain patients who have fractured a bone, depending on their background

• Individuals on medications or with medical conditions that can affect bone density

Bone density tests can also identify patients with osteopenia — decreased bone mass that has not yet reached the level of osteoporosis. 询问你的医生是否需要做检查.

其他工具和测试包括:

• FRAX score. combines your 骨密度测试 with other factors to estimate your risk of a fracture within the next 10 years

• 个人和家族病史

• 体格检查

• 使用其他机器进行额外扫描

• 血液和尿液测试

骨质疏松症的治疗

早期治疗骨质疏松症和骨质减少症可以减轻疼痛, 限制或停止骨质流失, 防止骨折. Appropriate treatment can also help fracture patients avoid another injury. 我们的医生根据以下方面推荐治疗方法:

• 你的年龄，整体健康状况和病史

• Your gender

• 疾病的严重程度和预期的骨质流失率

• 你对特定药物、程序或疗法的耐受性

• 你的意见或偏好

许多骨质疏松症的治疗工具与预防方法相似, 比如建议改变饮食和生活方式.

FDA也批准了一些注射, IV infusions, tablets, nasal sprays and patches — all shown to reduce fractures in randomized studies. 一定要和医生讨论可能的副作用.

甲状旁腺激素

Side effects: Possible calcium increases in the blood and urine and reactions at the injection site like itching and redness.

Drug: Teriparatide (甲状旁腺激素的一种)
Use: Treats postmenopausal women and men who are at high risk for fractures
形式:患者每日在家注射

Estrogen

副作用:风险vs. 益处应与医生讨论. 通常用于更年期早期的短时间, 因为有患乳腺癌和血栓的长期风险.

Drugs: 雌激素治疗 (ET) and 激素疗法 (HT)
Use: Increases bone density in the spine and hip and decreases fractures at both sites. 通常用于绝经后妇女的预防.
形式:通常为片剂或皮肤贴片

磷酸盐

Side effects: Oral bisphosphonates can cause upper stomach issues like heartburn. Patients can get flu-like symptoms after the first dose of intravenous bisphosphonates. 所有的双磷酸盐, there are rare side effects: Difficulty healing after dental work like a root canal or implant that involves the jaw bone (approximately 1 in 50,000名患者), 以及长期后的应力性骨折, 连续使用(约1 / 75),000名患者). 大多数医生会开这些药5-8年, then consider taking their patients off the treatment as fracture risk remains low even after stopping the medication. 停药后, bone density and blood testing annually can help determine when and if more medication would be helpful.

Drug: Alendronate钠
用途:预防和治疗绝经后妇女骨质疏松症 and treats the disease in men, 同时降低脊椎的风险, 髋部和其他骨折
形式:每周一片

Drug: Risedronate钠
用途:预防和治疗绝经后妇女骨质疏松症 and treats the disease in men, 同时降低脊椎和髋部骨折的风险
形式:每周或每月一次

Drug: Ibandronate钠
用途:预防和治疗绝经后妇女骨质疏松症 and reduces the risk for spine fractures
形式:每月服药或每3个月静脉注射一次

Drug: Zoledronic酸
用途:预防和治疗绝经后妇女骨质疏松症, treats the disease in men and prevents additional broken bones for fracture patients with low bone density. It reduces the risk of fractures of the hips, spine and other areas like the wrists and arms.
形式:每年静脉注射

选择性雌激素受体调节剂

Side effects: Possible hot flashes and a small increased risk of blood clots

Drug: Raloxifene
用途:预防和治疗绝经后妇女骨质疏松症 while reducing the risk of spinal fractures
形式:每日一粒

Calcitonin

Side effects: Approximately 6 percent of patients will have some mild nose irritation. The FDA reviewed the medication in 2013 because there may be a 1 percent increase in skin cancers. 该机构决定，它应该继续可用, 但是你应该和你的医生讨论一下风险和益处.

Drug: Calcitonin-Salmon
Use: Treats osteoporosis in women who are at least 5 years past menopause and reduces the risk of spine fractures.
剂型:鼻腔喷雾剂或注射剂

RANK-Ligand抑制剂

Side effects: Possible skin changes like rashes and eczema and a small increased risk of infection

Drug: Denosumab
用途:降低脊柱骨折的风险, hips and other areas for high-risk men and postmenopausal women with osteoporosis. It also prevents bone loss during some breast and prostate cancer treatments.
形式:由医生每六个月注射一次