|
|||||||||
|
|||||||||
|
|||||||||
|
||||||||||||
Ten million Americans over the age of 50 have osteoporosis, the most common bone disease, while another 34 million are at risk for developing osteoporosis. (3) The consequences of osteoporosis are financial, physical, and psychosocial, all of which can significantly affect individuals, family and community. People with HIV now have a higher prevalence of osteopenia or osteoporosis than in the past before widespread use of antiretrovirals. (11) This may also involve multiple endocrine, nutritional, and metabolic factors. (10) Obviously, people with HIV who know about bone disorders are in a much better position to avoid them. This issue concentrates on osteoporosis. Future HIV Nutrition Update issues will highlight other bone disorders experienced by people with HIV. |
Osteoporosis Risk Factors
Osteoporosis
is a significant risk factor for bone fracture. The incidence of osteoporotic
fracture is increased by various risk factors including compromised bone
strength. Much of the cellular activity in bone consists of removal and
replacement at the same site, a process called remodeling. (5) The remodeling
process becomes dominant by the time the body’s bone reaches its peak mass
(typically by the early 20s). Remodeling continues throughout life so most
of the adult skeleton is replaced about every 10 years. Dr. Riggs notes
bone mass varies over time depending upon how much new bone is being formed
and how much is being lost (resorption). (2) Differences exist between
risk factors that affect bone metabolism and risk factors for bone fracture.
Physiological, environmental, and modifiable lifestyle factors can play
a significant role in bone mass density (BMD). Blocking bone resorption
helps to decrease bone loss and prevent fractures as bone breakdown is
the first step to osteoporosis. Dr. Melton notes that the risk of disabling
and life-threatening fractures related to osteoporosis is high and there
is now a greater need for preventive strategies. (2)
Osteoporosis can be either
primary or secondary; primary osteoporosis is the most common form of this
bone disease. Primary osteoporosis is sometimes referred to as idiopathic
osteoporosis because the exact cause of the disease is unknown. It is mainly
a disease of the elderly due to cumulative bone loss and deterioration
of bone structure that occurs as people age. (5) For aging men, sex steroid
deficiency also appears to be a major factor in the development of primary
osteoporosis as it has an effect on calcium absorption and conservation.
This leads to progressive secondary increases in parathyroid hormone levels.
As testosterone can stimulate bone growth, decreased bone formation plays
a greater role in the bone loss experienced by elderly men than that of
post-menopausal women. Over 13% of men aged 50 will have a fracture sometime
in their life. (2) Younger individuals rarely get primary osteoporosis.
A negative balance of only 50-100 mg of calcium per day over a long period
of time is enough to produce this type of osteoporosis. This bone loss
can be minimized and prevented through adequate nutrition, physical activity,
and appropriate treatment if necessary.
|
No part of this newsletter may be reproduced in any form without permission from the publisher. Copyright 2005 HIV ReSources, Inc. Email: subscriptions@hivresources.com |
|
|
|
|
|
PO Box 39385 Fort Lauderdale, FL 33339-9385 USA |
|
Any use of the information presented herein is done strictly at your own risk. No responsibility is implied or intended on the part of HIV ReSources Inc, the editor, or the publisher. Information on this site should not be construed as an endorsement of any kind. |
|
|