 Home > Active Ingredient News > Endocrine System > Young men rarely suffer from osteoporosis! If you don't believe me, check it out

Young men rarely suffer from osteoporosis! If you don't believe me, check it out

 Last Update: 2023-01-06
 Source: Internet
 Author: User

Tags

prednisone 10 mg

bone loss physical exercise

Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

*For medical professionals only

Bian Pingda, director of Zhejiang Provincial People's Hospital, published the 63rd article
related to the prevention and treatment of osteoporosis in the medical community.

Not long ago, a 31-year-old married (with one son) Mr.
Yuan came to the osteoporosis clinic, saying that he found osteoporosis when he underwent quantitative ultrasound (QUS) bone density measurement at the physical examination center of a university affiliated hospital.
I want to mix some anti-osteoporosis drugs
.
I said, young men are rarely suffering from osteoporosis, at present QUS bone densitometry is mainly used for screening of people with osteoporosis in the community, suspected of having osteoporosis, may wish to do a dual-energy X-ray absorption method (DXA) bone densitometry
.

Mr.
Yuan's DXA bone densitometry results showed that the Z values of bone density in femoral neck, total hip and lumbar spine 1-4 were -2.
3, -2.
0 and -1.
5, respectively (see Figure 1), and the diagnosis was low bone mass [1]
。
Fig.
1 Results of Mr.
Yuan's dual-energy X absorption method bone density examination

Trivia: What is a T or Z value?

In DXA bone density measurement reports, the T value or Z value is generally used to judge the bone density level, where the T value is the result of the test subject's bone density compared with the younger population, and the Z value is the result of
the test subject's bone density compared with the same age group.
For postmenopausal women and men aged 50 years and older, choose a T-value to diagnose, such as a T value of ≤-2.
5 to diagnose osteoporosis; while for children, premenopausal women and men under 50 years of age, choose a Z value to diagnose, such as a Z-value of ≤-2.
0 to diagnose low bone mass or "lower than the expected range of the same age [1]"
.

Generally, men are at their peak bone density at age 31
.
Mr.
Yuan has no bad habits such as smoking, alcoholism, staying up late, no stroke, spinal cord injury, type 1 diabetes, rheumatoid arthritis and other diseases that affect bone metabolism, no long-term use of glucocorticoids and other drugs that affect bone metabolism, and serum antinuclear antibodies and other tests are also normal, how can it be low bone mass?

Do a quantitative computed tomography (QCT) bone density to see!
Mr.
Yuan's QCT bone density measurement results Mr.
Yuan's QCT bone density examination showed that the average bone density of lumbar spine 2-4 was 166.
49mg/^cm3 (see Figure 2), which significantly exceeded the standard of normal bone density （＞120 mg/cm³）^[2]
。 The diagnostic criteria for lumbar spine QCT bone density are shown in Table 1
.

Fig.
2 Table 1 Diagnostic criteria
of lumbar spine QCT bone density Therefore, Mr.
Yuan does not need to receive anti-osteoporosis therapy for the time being, but he should pay attention to drinking more milk.
Get frequent sun exposure, exercise consistently, and check
regularly.
DXA and QCT bone density examination The choice DXA is the use of two different energy X-rays to scan human bones to measure bone density, the main measurement sites are lumbar spine and hip, is currently widely used, repeatable, high recognition of the main bone density measurement method
.

However, DXA measures bone density (mg/^cm2) in area, so it is affected by the patient's fat and thin body, bone thickness, scoliosis, The influence
of factors such as bone hyperplasia, vertebral fractures, and vascular calcifications.

QCT is the use of CT equipment, the use of known density body model and corresponding measurement analysis software to measure bone density, is the current measurement of volumetric bone density (mg/cm³).
It can avoid the influence of the above factors on bone density measurement, and can accurately measure the bone density of the lumbar spine (mainly its cancellous bone), but the amount of X-ray radiation received by the test subject during QCT measurement is higher than that measured by DXA [3], and its repeatability is poor
.

Therefore, when the DXA measurement results are generally inconsistent with the patient's clinical situation, the additional QCT measurement is considered, and then a comprehensive judgment
is made according to the DXA and QCT measurement results.
Of course, in young men diagnosed with osteoporosis by DXA and QCT measurements, attention should be paid to finding the cause
.

References:

[1] Osteoporosis and Bone Mineral Disease Branch of Chinese Medical Association.
Guidelines for the diagnosis and treatment of primary osteoporosis (2017)[J].
Chinese Journal of Osteoporosis and Bone Mineral Diseases,2017,10(5):413-436.
) [2] Cheng Xiaoguang et al.
Expert consensus on imaging and bone density diagnosis of osteoporosis[J].
Chinese Journal of Orthopaedics,2020,40(16):1039-1044.
) [3]Damilakis J，Adams JE，Guglielmi G，et al.
Radiation exposure in X-ray-based imaging techniques used in osteoporosis[J].
Eur Radiol，2010，20(11):2707-2714.

Where to see more endocrinology clinical knowledge?
Come to the "doctor's station" and take a look 👇

This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.