An old man in his 60s fell and broke his bones for 2 consecutive years, and the bone quality was found to be poor after examination; the scene photo, the person in the picture has nothing to do with this article.

(picture taken from shutterstock)

[Health Channel/Comprehensive Report] An old man in his 60s fell and broke his bones for 2 consecutive years, 1 time with a thigh fracture and 1 time with a wrist fracture. He followed the advice of his relatives and friends and checked whether he was osteoporosis. The result was that the bone density value was normal, but Due to diabetes for many years, long-term poor control of blood sugar leads to poor bone quality.

The doctor pointed out that in the past, osteoporosis was defined as poor bone density, but later it was found that some people had no problem with bone density, but their bones were easy to break, so the definition was changed to poor bone density or poor bone quality.

Hong Weijie, director of the Department of Preventive Medicine, Department of Family Medicine, E-Da Hospital, posted on the Facebook page "Dr. Hong Weijie's Love Talk Space" and personal website that too high blood sugar will cause problems in collagen composition and bone cell metabolism, affecting bone structure and quality. In the long run, bone quality will deteriorate, and most of the time, the deterioration of bone quality in diabetic patients is more than the change in bone density. Therefore, diabetic patients should pay attention to bone quality even if the bone density test is normal.

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Not only bone density but also bone quality

He pointed out that bone density refers to bone density and bone mass, while bone quality refers to bone composition, arrangement and structure.

For example, when building a house, the same amount of cement is used. House A divides the cement equally on the four walls, while house B pours almost all of the cement on the north and south walls, and the east and west walls. The north and south walls of the house are very strong, but the east and west walls are very fragile, and they are prone to collapse in the event of an earthquake.

Hong Weijie said that the amount of cement can be imagined as bone density. The overall bone density is the same, but if the bone structure is unevenly distributed, it will easily collapse like house B when it encounters an external force.

However, there are many diseases and drugs that affect bone quality, and the following are all factors:

• Diabetes.

● Hyperparathyroidism.

● hypogonadism.

● Cushing's disease: a hyperactive adrenal glands, excess adrenal cortisol.

●Too little physical activity.

●Osteomalacia.

● Long-term steroid use.

●Cancer chemotherapy drugs.

●Adjustment of anti-rheumatic drugs.

Hong Weijie said that currently there is something called Trabecular Bone Score (TBS) to check bone quality, which can be evaluated together with X-ray bone density examination. A score of 1.35 or higher is considered good bone quality, and a score of 1.20-1.35 is considered good quality. Poor, below 1.20 is poor quality.

The old man's examination result was 1.042, which is far from the normal standard. Therefore, although the bone density is good, the bone quality is not very good, and it is easy to fracture when falling.

He emphasized that bone density is as important as bone quality, just as quantity is as important as quality.

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keywords

• diabetes

• fracture

• Osteoporosis

• broken leg

• calcium

• bone density test

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