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OSTEOPOROSIS

OSTEOPOROSIS. Florence TREMOLLIERES, MD, PhD Menopause and Metabolic Bone Diseases Center Hôpital Paule de Viguier University Hospital of Toulouse Toulouse, France. Postmenopausal osteoporosis. Physiopathology of osteoporotic fractures Epidemiology and consequences of fractures

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OSTEOPOROSIS

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  1. OSTEOPOROSIS Florence TREMOLLIERES, MD, PhD Menopause and MetabolicBoneDiseases Center Hôpital Paule de Viguier UniversityHospital of Toulouse Toulouse, France

  2. Postmenopausalosteoporosis • Physiopathology of osteoporotic fractures • Epidemiology and consequences of fractures • Assessment of the risk of fracture • Risk factors • Measurement of bone mineral density • Bone turnover markers • Current treatment options • MHT and the prevention of osteoporosis at menopause • The future of osteoporosis treatment

  3. Osteoporosis "A systemic disease characterized by low bone mass and micro-architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk" WHO definition, 1994 Healthy bone Osteoporotic bone

  4. Pathophysiology of osteoporotic fracture Skeletal factors Extra-skeletal factors Quantitative factors Qualitative factors Type of trauma Way of falling Microarchitectural defects Protection... Low BMD Bone remodeling Geometry (hip axis length...) Bonefragility Trauma FRACTURE

  5. Epidemiology of fracture • 200 million people worldwide suffer from osteoporosis1 • 30% of postmenopausal women have osteoporosis in the US and Europe2,3 • At the age of 50 yr, the combined lifetime risk of hip, forearm and vertebral fractures in women is around 40%, which is equivalent to the risk of cardiovascular diseases4 • In US women 55 yrs and older, the hospitalization burden of osteoporotic fractures is greater than that of myocardial infarction, stroke, or breast cancer5 • Ageing of populations worldwide will be responsible for a major increase in the incidence of osteoporosis in postmenopausal women. By 2050, the incidence of hip fracture is projected to increase by 240% in women6 1. Cooper C, et al. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992; 2:285-9 - 2. Melton III LJ, et al. Perspective: How many women have osteoporosis? J Bone Miner Res 1992; 7:1005-10 - 3. EPOS Group. Incidence of vertebral fracture in Europe: Results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res 2002;17:716-24 - 4. Cummings SR, Melton III JR. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002; 359:1761-7 - 5. Singer A et al. Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc 2015; 90:53-62 - 6. Sambrook P, Cooper C. Osteoporosis. Lancet 2006; 367:2010-18

  6. Incidence of osteoporotic fracture in postmenopausalwomen 40 Vertebrae 30 Yearly Incidence per 1000 women 20 Femur 10 Wrist 50 60 70 80 Age Wasnich RD: Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 4th edition, 1999

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