【Osteoporosis Clinic】

Osteoporosis is a “pathological aging” of the bones, and fractures occur as a complication due to the brittleness of the bones, necessitating prevention and treatment. To prevent osteoporosis, it is important to first significantly increase bone mass. However, in women, bone mass rapidly decreases after menopause, making it necessary to screen women with reduced bone mass early after menopause to prevent further loss of bone mass. Furthermore, for elderly individuals whose bone mass has already significantly decreased, maintaining bone mass and preventing falls are crucial.

The prevalence of osteoporosis in people over the age of 40 is reported as 3.4% in men and 19.2% in women for lumbar vertebrae (L2-L4), and 12.4% in men and 26.5% in women for the femoral neck. It is estimated that there are approximately 6.4 million osteoporosis patients in the lumbar vertebrae (800,000 men and 5.6 million women) and approximately 10.7 million patients in the femoral neck (2.6 million men and 8.1 million women).
Vertebral fractures and femoral neck fractures tend to increase rapidly after the age of 70. Vertebral fractures occur in 5.1% of men and 14% of women in their 60s, and in 10.8% of men and 22.2% of women in their 70s.

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【Prevention of Locomotive Syndrome】
Locomotive syndrome is defined as “a condition where mobility function declines due to disorders of the musculoskeletal system,” and progression increases the risk of requiring nursing care. To prevent locomotive syndrome, it is essential to:
① Develop exercise habits,
② Ensure proper nutrition intake, and
③ Appropriately treat musculoskeletal diseases. These measures are important for preventing falls and dementia. Since fractures caused by osteoporosis can worsen locomotive syndrome, regular bone density assessments become crucial for individuals over 50.

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【Tests】
Osteoporosis leads to decreased bone density and increased fragility due to the acceleration of bone remodeling (bone resorption). Causes include changes in bone matrix proteins due to deficiencies in Vitamin D or Vitamin K. Detailed fracture risk assessments can be conducted through blood tests for bone-related markers and bone density measurements (using the DXA method).

• Blood Tests (Bone-related markers): Conducted every 3 months to 1 year.
  Includes: Albumin, calcium, inorganic phosphorus, blood count, TRACP-5B, type I procollagen N-terminal propeptide, 25-OH Vitamin D.
• Bone Density Measurement via DXA (Dual-Energy X-ray Absorptiometry): Conducted every 4 months to 1 year.
  Includes:
  Lumbar spine DXA (L1–L4 or L2–L4).
  Proximal femur DXA (covering three regions: neck, trochanter, and diaphysis).

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(Source) Japan Osteoporosis Society: Guidelines for Prevention and Treatment, 2015 Edition.

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