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Milan, October 19 (Health AdnKronos) – Every 3 seconds in the world, a bone breaks because of osteoporotic fragility: fractures of the wrist, vertebrae or femur, which occur 25,000 times a day or 9 million per year. The Oms figures, which figure among the successes of the 2018 edition of World Osteoporosis Day. The anniversary is celebrated on Saturday, October 20th under the banner of the claim "This is a sign", an invitation to learn to recognize and not to underestimate the severe osteoporosis warning tones launched by Iof (International Osteoporosis Foundation) and shared by experts of the "Stop Fracture" campaign, an educational initiative launched in 2011 and aimed at over 50s. Women and men, because the disease of fragile bones is not a feminine exclusivity. It suffers about half, but with perverse effects: more frequent disability, double risk of death in the year following a femoral "crack".
Made with the unconditional support of Eli Lilly Italia, this initiative concerns the scientific societies Siommms (Italian Society of Osteoporosis, Mineral Metabolism and Skeletal Diseases), Siot (Italian Society of Orthopedics and Traumatology), Sir (Italian Society of Rheumatology), Ortomed (Italian Society of Orthopedics and Medicine), Gisoos (Italian Group for Studies in Orthopedics of Severe Osteoporosis) and Gismo (Italian Group for Studies of Bone Metabolic Diseases). The main tools are the website www.stopallefratture.it and the Facebook page "StopalleFratture", which has more than 40,000 "likes".
About 4 million women and 1.5 million men: many fall prey to the "silent bone" thief in Italy. It is estimated that 50% of peers over the age of 50 and 30% of male peers will be confronted with a fragility fracture: shares intended to grow with the aging of the population, as well as its medical, health, social and economic weight . However, for specialists, osteoporosis is "a disease that is still too often underestimated, under-diagnosed and under-treated". And to win the enemy, we must anticipate the movements, "the first crucial point of the approach of this disease – explains to AdnKronos Health, Luigi Sinigaglia, director of rheumatology of 39; AST Pini-Cto of Milan – is the badysis of the risk factors that are numerous ": from age to familiarity with fractures (the present one Italian out of 3), from the physical structure (excessive emaciation, decreased stature) to bad lifestyles including smoke or alcohol abuse, concomitant pathologies to taking certain medications.
Early menopause, which affects 4 to 5% of women, "is, for example, a huge risk factor for dealing with the fragility of the skeleton". As "sedentary lifestyle", it enumerates the expert. Or "taking little calcium in foods, dairy products such as milk, yogurt or cheese". Again: "Whoever has a mother who has had vertebral fractures, or a fractured femoral neck in the last part of life, has a greater risk of skeletal fragility than those who do not have that." kind of familiarity ". Bones are therefore more "under fire" in patients with rheumatic diseases, diabetes, pneumological diseases (Bpco), neurological (Parkinson's, multiple sclerosis), inflammatory bowel disease. As well as in people taking mainly cortisone, but also antiepileptics, anticoagulants, anticancer inhibitors of aromatase.
Then there is what in the medical language they call "domino effect", the "tsunami" of the "fracturing cascade". This means that "to have a fragility fracture – warns Sinigaglia – is certainly the most formidable risk factor for having others, and this is true not only at home (having a vertebral fracture, for example, exposes the patient greater risk of future vertebral fractures) ", but also" transversely "for all sites:" Young women who fall over 50 years and fall on their wrists may suffer somatophatic vertebral fractures or femoral neck much higher than the control population ". The data confirm: after a vertebral fracture, 25% of patients report a second less than a year and the risk of fracture of the quadruple femur. And after a first fracture of the femur, the chances of refraction increase from 9% in the first year to 20% in the fifth year.
The figures, although very high, are however considered inferior to the real ones. This is particularly the case of "fractures of the vertebral bodies: they are often painful and cause a functional disability for a time, but many are completely submerged – observes the specialist – because they do not give symptoms and can be misunderstood. there are several hundred thousand fractures a year in our country, but the estimate is certainly a small loss due to the fact that all these fractures are not recognized quickly ". Those of the femur, "about 90,000 to 100,000 every year in Italy", are certainly more obvious and yet they pose a problem: in hospitals, "patients are found in orthopedic divisions and are often never studied; therefore do not come treated, from the point of view of skeletal fragility ".
In summary, in the war against severe osteoporosis "the badysis of the risk profile is the first crucial point", Sinigaglia repeats, which calls into question "the general practitioner (sees first the patient and can perfectly put in place one of the targeted surveys) ", as well as" the patient himself "who can find" a questionnaire providing a risk score "on the Web, on the site Stop Fracture.
This is the "online DeFra79 test", a self-diagnostic tool reviewed in the light of the new AIFA's Italian Medicines Agency rating of 79, which allows you to badess your personal risk – low, medium, high , very high – to fracture 10 years later. "Usually, says the expert, these questionnaires should be combined with the instrumental data of bone densitometry, which does not specify whether the patient has osteoporosis, but can detect reduced bone density." Risk Factor Fragility Fractures ".
"Recent international studies – observes Maurizio Rossini, who directs in Verona the specialty school in rheumatology of the city's university and the complex operating unit of rheumatology of the integrated university hospital – have shown that, if the patient does not have a correct perception of fracture risk, the onset and adherence to treatment are compromised, which increases the risk of experiencing one of these events "which often have unfortunate consequences : for hip fracture, in particular, up to one year there is a loss of function of 50% and a mortality of 20%. Instead, "with the new DeFra79 online test, it is possible to know the degree of risk to the health of your own bones and receive advice on the opportunity to discuss with your doctor or consult a doctor. specialist".
Today, we still tend to view osteoporosis as a physiological consequence of aging – says Silvia Migliaccio, a specialist in endocrinology and metabolic diseases, badociate professor at the Foro Italico University in Rome – under In fact, fractures of bone fragility can actually occur "even in the absence of a real trauma, such as a lump or a fall." Effort, such as raising the basket, is enough: osteoporosis is therefore an important public health problem, which has a significant social impact as it negatively affects the quality of life of women who sometimes suffer for decades. "
Orthopedist Alfredo Nardi repeats about women and men: "Even men's bones become fragile and more likely to fracture, even in minimal trauma – he says – osteoporosis in humans is a problem that is often overlooked by male patients, who often suffer from loss of consciousness following fragility fractures ". Suffice it to say that "for 50 years, the risk of fracture for a man is greater than the risk of contracting prostate cancer".
"Osteoporosis has always been considered a predominantly female disease," recognizes Sinigaglia. In fact, "today, we know that about 20% of women after menopause begin to lose calcium from their bones and that this represents the antechamber of fracture risk, but we also know that osteoporosis is a serious and epidemiologically important problem in humans ". Whatever his bad, the expert insists on the importance of a "correct diagnosis, which must be done – he said – only after excluding other diseases which can induce fragility of the skeleton ". That said, "the forms of osteoporosis consecutive to other diseases are much rarer". While "idiopathic osteoporosis, its essential form, is very common and affects a very large part of the population, mainly of advanced age, but not necessarily".
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