OsteoporosisOsteoporosisSlide showSlide show

The Osteoporosis LandscapeThe Osteoporosis Landscape

In India, an estimated 43 million women suffer from osteoporosis

India: Some Hard Facts India: Some Hard Facts Over 61 Million Indians have

osteoporosis.

80% are women.

On a global basis, Indians have the highest prevalence of osteopenia.

Compared to Caucasians, osteoporotic fractures in the Indian population occur 10-12 years earlier in age.

Osteoporotic fractures are more common in Indian men than in the West.

India: Some more hard factsIndia: Some more hard facts

Over 45 Lakhs Indian women above 60 have a fractured spine.

Over 2.5 Lakhs Indians suffer osteoporotic hip fractures every year.

Most of these fractures are never investigated for osteoporosis - and therefore never treated for the cause.

Gupta et al, Indian Journal of Medical Research 1967:55:1341-8

Incidence of Hip fracturesIncidence of Hip fractures

Asia will emerge as the largest sufferer of osteoporosis related

fractures

Osteoporosis vs other Osteoporosis vs other diseasesdiseases

Total incidence of osteoporosis related fractures far exceeds other

diseases

What makes us more prone?What makes us more prone? Indians have a poor calcium intake

– We don’t drink enough milk as children– We have a higher incidence of varied degrees of lactose intolerance– Rice is a poor source of calcium– Vegetarian diets and cereals have low bio-availability of calcium

(<30%)

Vit D deficiency is common

Protein intake is poor

Excess salt intake – may increase urinary loss of calcium

Healthy exercise is neglected

Significantly lower BMD: mean spinal BMD by DEXA is 2SD below the American-European population between 20 to 59 yrs population*

Lower BMI: osteoporosis is more common in thin women

Late menarche’ in girls - low estrogen exposure

Awareness is low*Nangia et al, ESICON 1977

Why is osteoporosis serious?Why is osteoporosis serious?

It affects many more women than heart attacks, strokes and breast cancer together

Osteoporosis kills by its complications-An osteoporotic fracture reduces the sufferer’s life expectancy by a decade.

In addition, it seriously compromises quality of life

Fractures are very expensive to treat-the economic burden of osteoporotic fractures is immense.

Common Fracture/BMD Common Fracture/BMD measurement Sitesmeasurement Sites

World Health Organization (WHO)World Health Organization (WHO)

guidelines for osteoporosisguidelines for osteoporosis

Osteoporosis Osteopenia

Normal

Peak Bone Mass

-2.5 -2 0T-Score -1

Who to Treat?Who to Treat?

Therapy Decision

High Risk

Treat

Moderate Risk

Treat if other risk factors

Low Risk

Check again in 1-2 years

T-Score*

Below -2.5

-1.0 to -2.5

Above -1.0

International Osteoporosis Foundation. 1998.

Osteoporosis: a team work

Patient & Family

Dietitian

Physio.

Govt.NGO

Sp. Doctor

OrthotistFm. Doctor

Sp. NurseOrthopaedic

Surgeon