Shining a Light on Osteoporosis: An Interview with MD, Jana Koporcová

Osteoporosis is a bone disease affecting millions of people worldwide and is referred to in medical circles as the ‘epidemic of the third millennium’. Characterised by weak and brittle bones, osteoporosis increases the risk of fractures and fragility. It’s called a ‘silent’ disease because it often displays no symptoms until a bone is broken. At Unilabs, we provide comprehensive diagnostic procedures to detect and manage this condition effectively. We spoke with Unilabs Slovakia Medical Manager, MD Jana Koporcová, to understand how osteoporosis can be diagnosed and prevented.

Which healthcare professionals help in managing osteoporosis?

The management of osteoporosis requires a multidisciplinary approach involving various specialists who can support in the prevention and treatment of low bone density and postmenopausal osteoporosis. This includes physicians who specialise in the fields of endocrinology, orthopaedics, rheumatology, internal medicine, and gynaecology.  Additionally, oncologists also have an important role to play, particularly when it comes to the management of patients undergoing androgen deprivation therapy (ADT) and anti-estrogenic treatment, as both these therapies can disrupt the balance of hormones that are essential for bone metabolism, significantly increasing the risk of bone loss and osteoporosis. 

What are the standard diagnostic procedures for detecting osteoporosis?

Diagnosing osteoporosis involves the measurement of bone mass content, with densitometry (a procedure that passes x-rays with two different energy levels through the bone) being the gold standard. This examination can be indicated by any physician, regardless of their specialty, if the indication criteria for the examination are met. Densitometry is a key tool in assessing bone density and identifying patients at risk of fracture.

How do laboratory tests help in the evaluation of osteoporosis?

Biochemical examination can help to evaluate the rate of bone metabolism and can aid in the differential diagnosis of secondary osteoporosis and other skeletal diseases. Basic laboratory investigations include a complete blood count (CBC) and numerous other blood tests, including those for bone turnover or bone resorption markers.

What examinations are still available for the differential diagnosis of osteoporosis?

To exclude individual diseases leading to secondary osteoporosis, other specialised laboratory examinations may be required. These include erythrocyte sedimentation rate (ESR), 24-hour urine cortisol, follicle-stimulating hormone (FSH), and many more.  Genetic testing for the COL1A gene may be performed for diagnosing osteogenesis imperfecta, also known as brittle bone disease. Other tests, such as tryptase and histamine levels, may also be considered. These tests help to identify and rule out conditions that may mimic the symptoms of osteoporosis.

How do these diagnostic procedures help in managing osteoporosis?

Laboratory tests do not establish a clinical diagnosis of osteoporosis, but they aid in making a differential diagnostic statement and they provide insight into ongoing bone metabolism. These examinations also help to rule out other metabolic and tumour diseases of the skeleton, and can specify the cause of secondary osteoporosis. By assessing bone density and biochemical markers, and conducting a thorough differential diagnosis, healthcare professionals can develop tailored treatment plans. Early detection and appropriate treatment can significantly reduce the risk of fractures, improve quality of life, and prevent complications associated with osteoporosis.

Who can be affected by osteoporosis and why?

Osteoporosis mainly affects menopausal women and older people, although men are not excluded. The increase in the incidence of osteoporosis has been attributed to both an ageing population and lifestyle changes, such as reduced exercise, automation of tasks, increased screen time, changes in eating habits, and smoking. 

What preventive measures can be taken to reduce the risk of osteoporosis?

Primary prevention involves maximising bone mass during childhood and adolescence. Regular intake of vitamin D and calcium, along with regular exercise, are essential for bone quality, even after the age of 30. The best exercise involves regular weight-bearing activities that don't overload the bones. A simple solution is a 30-minute daily walk or dancing. In terms of diet, it's important to consume plenty of vegetables, fruits, fibre, and healthy sources of protein and fats, while limiting sugar and salt intake. Avoiding smoking, alcohol consumption, and excessive caffeine intake is also advisable.