Osteopenia refers to a decrease in bone mineral density (BMD) in the body, resulting in the weakening of bones. It is associated with older people, especially women. The disease has no signs and symptoms for detection. BMD is diagnosed using dual-energy x-ray absorptiometry (DXA) bone scans. The World Health Organization (WHO) diagnosis of Osteopenia is a t-score between -1 to -2.5, while values less than -2.5 are diagnosed as Osteoporosis (Zhai et al., 2022). The physical exam test for a range of diseases is regular except in some instances of advanced diseases such as Osteoporosis. The recommendation by clinicians for ordinary and healthy individuals without specific risk factors varies depending on gender. For instance, women approaching menopause (Or by age 65 years at the latest) and males are recommended by clinicians to take the test at the age of 70 years and above.
Osteopenia is a clinical term that describes the reduction in bone mineral density(BMD) below the average reference values in a healthy individual but still too low to be considered osteoporotic under diagnostic criteria. Osteoporosis is a bone disease that develops when bone mineral density and bone mass result in a reduction. The reduction in bone strength increases the risk of bone fracture under Osteopenia. The condition of Osteopenia does not always indicate that the person has Osteoporosis. Osteoporosis depends on various risk factors that result in bone fractures. Osteopenia condition can be treated and healed without being infected with Osteoporosis.
Parathyroid hormones- parathyroid gland produces a parathyroid hormone (PTH), a polypeptide, in response to the low calcium levels in the blood—the synthesis of active vitamin D and calcitriol (1, 25-dihydroxycholecalciferol) in the kidney. PTH regulates the calcium and phosphate in the blood in conjunction with calcitriol. PTH help to regulate and change the processes in the kidney, bones and small intestines. The reduction in the serum calcium levels in the blood alerts parathyroid glands to produce PTH, which helps to regulate the calcium levels; an increase in the Parathyroid gland’s calcium levels leads to the production of negative feedback that helps to signal the Parathyroid glands to return to normal. The functioning of the PTH in the blood is intricate and hence needs medications(Lee & Shin, 2022). The C-cells of the thyroid glands secrete the calcitonin hormone. It helps to regulate the calcium levels in the blood by inhibiting the osteoclasts’ functions and activities in the bones. The hormone lowers the calcium levels in the body, which may result in the growth of Osteoporosis.
Calcitriol is the active form of vitamin D formed in the kidney to regulate calcium in the blood. It is also called 1, 25-dihydroxycholecalciferol. The primary role of calcitriol is to increase the blood calcium in the body through an increase in the uptake of calcium from the intestines. Blood calcium regulations in the body help to increase the strength of bones. Furthermore, it can be provided as a medication for the treatment of low blood calcium in the body, resulting in various diseases such as low blood calcium and hyperparathyroidism due to kidney diseases. Calcitriol is secreted in the cells of the proximal tubule of the nephron in the kidneys by the action of 25-hydroxyvitamin D3 1-alpha-hydroxylase, a mitochondrial oxygenase and an enzyme that catalyzes the hydroxylation of 25-hydroxycholecalciferol.
Antacid medication decreases the calcium absorption rate in the body, leading to calcium deficiency. The reduction of calcium absorption in the body is because of damage in calcium regulation hormones by the antacids detergents. The medications tend to lower the functions and activities of the hormones such as PTH and Calcitriol elements in the body, ceasing their regulation in the blood. Failure of the hormones results in a decrease in bone mineral density (BMD), leading to osteopenia conditions resulting in bone fracturing.
Building bones is made possible at the age of 52 because of a wide range of requirements that individuals could implement to support the growth of bones. Some of the requirements include eating food rich in calcium, Vitamin D and proteins daily to help strengthen the bone and increase the activities of regulating the hormones on calcium level in the body. Furthermore, it entails regular exercises such as weight-bearing exercises that help to maintain a healthy body. Individuals should avoid other activities that decrease bone weight such as smoking and alcohol.
Caffeinated contributes to decreased bone mass and increased fracture risk because of some ingredients found in caffeine-beverage consumption. The caffeine-beverage consumption contains chemicals that block the activities of the hormones that work on the regulations of blood calcium in the blood of healthy individuals. The blockage interferes with the normal breakdown of hormones in calcium and phosphate leading to an effect in calcium excretion. However, research revealed that caffeine-beverage consumption does not affect bone mass, but to some level, it interferes with the normal regulation of blood calcium.
Post-menopausal leads to reduced bone mass because of the fall in estrogen levels in the body. Estrogens regulate the rate of menopause in the body leading to increased bone mass in women. Estrogen acts as an enzyme in the regulation of metabolism in normal human beings. A fall in the activities of Estrogen leads to a failure in the regulation of metabolism in both men and women, leading to a decrease in bone mass. After menopause, the rate of Estrogen falls, leading to a deficiency in its function that results in a decrease in the rate of bone formation and bone resorption in the cellular cells. Estrogen affects the body’s functions on osteocytes, osteoclasts and osteoblasts that block bone remodelling, leading to a loss of bone mass and risk of fracture of bones.
Vitamin K helps in the building of bone by increasing the growth of serum necessary to protect and prevent the fracturing of bones. Furthermore, Vitamin B12 plays a vital role in increasing bone mineral density. The study suggests that food rich in vitamin B12, such as fish, liver, beef, pork, milk and cheese, is necessary for regulating blood calcium in the body, leading to bone formation and reabsorption. Vitamin B3 is also essential for strengthening bones by aiding calcium retention (Huang et al., 2022). Some minerals play an important role in bone-building; such minerals include; magnesium which plays essential roles in increasing bone stiffness, decreasing osteoclasts and increasing osteoblasts necessary for the growth of bones. It also helps regulate blood calcium by helping PTH, and vitamin D. Phosphorus helps regulate the gut, kidney and bones, which involves multiple regulators in the body. The absence of phosphorus minerals fails in some body systems, such as kidneys, guts and bones, leading to osteomalacia.
Anti-seizure medications and epilepsy are associated with the worst effects on the bone of a healthy person. Treating epilepsy with anti-seizure medications increases the loss rate of bones and mineral metabolism, resulting in adverse effects of the fracturing of the bones. Anti-seizure medications decrease the normal functioning of the PTH on the minerals such as calcium and magnesium leading to an abnormality in the bone and mineral metabolism resulting in Osteoporosis. However, Osteoporosis can be managed through medication and eating a healthy, balanced diet rich in minerals such as calcium and vitamin D to retain the calcium level in the body.
Reference
Zhai, T., Chen, Q., Xu, J., Jia, X., & Xia, P. (2022). Prevalence and trends in low bone density, Osteopenia and Osteoporosis in US adults with non-alcoholic fatty liver disease, 2005–2014. Frontiers in Endocrinology, p. 12, 825448.
https://www.frontiersin.org/articles/10.3389/fendo.2021.825448/full
Lee, D. Y., & Shin, S. (2022). Association of sarcopenia with Osteopenia and Osteoporosis in community-dwelling older Korean adults: A cross-sectional study. Journal of Clinical Medicine, 11(1), 129.
https://www.mdpi.com/1424142
Huang, J. F., Tan, Q. C., Bai, H., Wang, J., Bergman, M., & Wu, Z. (2022). Bone mineral density, Osteopenia and Osteoporosis among US adults with cancer. QJM: An International Journal of Medicine, 115(10), 653-660.
https://academic.oup.com/qjmed/article-abstract/115/10/653/6517211
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