Iindlela zokwelapha kwi-Osteopenia (i-Bone Low)
Ukuba uye wafumanisa ukuba unesifo se-osteopenia (ubukhulu besifo seethambo) ugqirha wakho usenokuba wacebisa unyango. Ziziphi iindlela zonyango ezikhoyo xa 'ungenayo' i-osteoporosis, kwaye nini kunenzuzo yokuqwalasela unyango?
I-Osteopenia: Ubunzima beB Bone
I-Osteopenia ithetha ukunyamekela kwethambo, kodwa oko kuthetha ukuthini oko? Kulula ukuqonda i-osteopenia xa siqhathanisa nokuba sisiswini esisisigxina somzimba kunye ne-osteoporosis (ubuncinci beethambo).
Ubunzima beethambo obuqhelekileyo kuthetha ukuba ubuninzi kunye nokwakhiwa kwamathambo akho aqhelekileyo. Kuvavanyo lwexinzelelo lwethambo , inombolo oyayiyoyibona ukuba ubukhulu benthambo yakho buqhelekile buya kuba ngaphezu kwe--1.0. Ngamanye amazwi, ubukhulu beethambo bakho buya kuba okanye bubhetele kunokwehluka komgangatho omnye ngaphantsi kwexesha eliqhelekileyo.
I-osteoporosis yimeko apho amathambo aye aphefumula kwaye asemandleni okuwaphula, nangona ukulimala kancinci. Uvavanyo lweethambo loxinzelelo lwe-osteoporosis lunikeza i-T-score ye--2.5 okanye ngaphezulu, oku kuthetha ukuba ukunyameka kwethambo lomntu kungama-2 standard deviation under the thickness of bone of adult adult or worse.
I-Osteopenia ilala phakathi kwala manani, kunye ne-T-score engcono kune--2.5 kodwa engaphezu kwe -0.1. Ithuba lokuba i-osteopenia iya kuqhubela phambili kwi-osteoporosis incike kwiminyaka yakho, ezinye izimo zonyango onayo, unyango oluthathayo, kunye nokunye okuninzi.
Ukunyanga i-Osteopenia
Kukho izinto ezininzi zokuqwalasela phambi kokunyanga i-osteopenia, kwaye ngoku kungumxholo okhusayo neshushu.
Ukuba i-osteopenia idibene neentlobo, mhlawumbi ukuba unyango lunokwenza umehluko. Akucaci kakuhle ukuba unyango lwe-osteopenia ngaphandle kwemfucuza luncedo.
Kukho imichiza evunyiweyo ye-FDA yokuthintela i-osteoporosis (kwaye ngoko-osteopenia). Ezi mpilisi ziyasebenza kodwa ezinye zazo zinemiphumo emibi.
Abanye oogqirha bayanqikaza ukunika imithi ye-osteoporosis ye-osteopenia ngelixa abanye bebugwenxa bezama ukunciphisa ukulahleka kwethambo. Injongo yokwenene ekuphatheni i-osteopenia kunye ne-osteoporosis iyakukhusela i-fractures, ingakumbi yesikhumba kunye nomgudu. Oogqirha banako ukubala umngcipheko we-10 we-fracture mngcipheko ngokusekelwe kwimeko yakho yangoku yetyhurensi yamathambo kunye nezinye izinto ezinobungozi. Lo mngcipheko weminyaka eli-10 uyona nto ingqalelo xa ucinga ngokuthatha unyango lwe-osteopenia.
Inqaku elincinane, nangona kubalulekile, kukuba iinkampani ezininzi ze-inshorensi zempilo aziqapheli i-osteopenia njengemeko efuna unyango kwaye ngenxa yoko ayikwazi ukumboza iindleko (ngamanye amaxesha zininzi) kwezi zi yobisi.
Xa kufuneka i-Osteopenia ilandelwe?
Njengoko kuphawuliwe ngaphambili, unyango lwe-osteopenia luphikisana. Oko kwathiwa, xa unyango luqalisiwe kweli nqanaba kubantu abakulindeleke ukuba baqhubele phambili kwi-osteoporosis, okanye banezinye iimeko, ukunyanga i-osteopenia kunokuthintela uphuhliso lwe-osteoporosis kunye neziqhekeza. Iimeko apho i-osteopenia ingaba yingozi ngakumbi ibandakanya:
- I-Osteopenia ifunyenwe kumntu oselula, umzekelo, umntu oneminyaka engama-50 ubudala kuphela.
- Abantu abanomhlaza, ngakumbi abo abanomdlavuza wesibeletho okanye umhlaza wesibeletho oya kusebenzisa i-hormonal therapies.
- Abantu abaye kwixesha elide le-steroids kwiimeko ezifana ne-asthma, i-COPD, okanye i-arthritis evuthayo.
- Abo baneemeko ezinxulumene nobungozi bokunyuka kwe-osteoporosis ezifana ne-lupus, i-rheumatoid arthritis kunye nabanye abaninzi.
- Abo banokuthi bawa ngenxa yeemeko zonyango ezifana ne-disorder seizure okanye ezinye izifo ze-neurological.
- Abo baneenkcukacha ezinobungqina bentsapho ye-osteoporosis.
- Abo bavelelekile kwaye bahlaselwe yinyama.
Amachiza okukhusela i-Osteoporosis (unyango lwe-Osteopenia)
Kukho amaninzi amachiza ahlukeneyo avunyelwe unyango lwe-osteoporosis , kodwa bambalwa kuphela abavunyelwe ukukhusela kuquka u-Actonel no-Evista.
Siza kuluhlu olukhethwa kukho unyango lwe-osteoporosis, njengamanye amayeza angaphandle kwalawo avunyelwe i-osteopenia (ukuthintela i-osteoporosis) ingaboniswa. Iindidi ezahlukeneyo zonyango zibhalwe ngezantsi.
Bisphosphates
I-bisphosphonates yimishanguzo eyenza ngokunciphisa izinga lokulahlekelwa kwethambo nokuphucula ukuxinwa kwethambo. Uninzi lwalo lunciphisa umngcipheko weemfucuza zomthunzi, kodwa akubona bonke abonakaliswe ukunciphisa umngcipheko wokuqhaqha. Ezinye zala mayeza azithathwa ngomlomo ngelixa ezinye zinikezwa ngejoza. I-Actonel, ngokukodwa, ivunyiwe ukukhusela i-osteoporosis. I-Zometa sele ivunyiwe ukuba isebenzisane kunye ne-aromatase inhibitor ekwenzeni unyango lomhlaza we-postmenopausal.
Amachiza kule candelo abandakanya:
- I-Fosomax (i-alendronate): I-Fosomax ibonakala iyanciphisa i-hip ne-spine fractures.
- I-Actonel (i-risedronate): I-Actonel inokunciphisa umngcipheko we-hip kunye ne-spin fractures.
- I-Boniva (ibandronate): I-Boniva iyanciphisa umngcipheko weemfucuza zomthunzi kodwa awuyikuqhaqha.
- I-Zometa okanye i-Reclast (i-zoledronic acid): Okunikezelwa ngumjovo, i-Zometa inciphisa umngcipheko we-hip and spine fractures.
Imiphumo emibi ye-bisphosphonates iyahluka ngohlobo lokuba isetyenziswe ngomlomo okanye nge-injection. Ngomlomo we-bisphosphonates, abantu bacelwa ukuba bathathe le mayeza ngeglasi yamanzi kwaye bahlale bemi-30 ukuya kweyimizuzu engama-60. Ezi ziyobisi zingabangela ukutshabalalisa okanye ukucaphukisa. Amachiza angenayo ayinokubangela iimpawu ezinjengomkhuhlane omnye ngosuku okanye ezimbini emva kokujova kwaye zingabangela iintlungu zomzimba kunye nentsebenziswano.
Isiqhelo esingaqhelekanga kodwa sisisigxina se-osteonecrosis somhlathi. Abantu abanesifo sezinsini okanye ucoceko lwamazinyo, banesicingo samazinyo okanye bafune iinkqubo ezifana nokukhutshwa kwezinyo zisengozini enkulu. Ezinye iimpembelelo eziqhelekanga zibandakanya i-fibrillation ye-acriary kunye nama-femy fractures atypical.
I-Module ye-Selective Acceptor Modulators (Evista kunye neTamoxifen)
Iimoduli ze-estrogen ze-receptor (SERMS) zonyango ziyakwazi ukuba ne-estrogen-kunye ne-anti-estrogen kwimiphumo ngokuxhomekeka kwinxalenye yomzimba abakwenzayo. I-Evista (raloxifene) ivunyelwe ukuthintela i-osteoporosis kubasetyhini abasemva kwe-postmenopausal kwaye kucatshangelwa ukunciphisa ingozi yomhlaza wesisu. I-Tamoxifen isetyenziselwa abafazi abanomdlavuza we-premenopausal we-estrogen receptor ezintle ukwenzela ukunciphisa umngcipheko wokuphindaphinda. I-Tamoxifen ingasetyenziselwa ukunciphisa umngcipheko wokuvelisa umdlavuza webele.
Njenga-estrogen (njenge-hormone therapy substitution) isenzo sabo kwithambo sandisa ubuncwane bamathambo kunye nokunciphisa umngcipheko we-vertebral (spinal) fractures. Ngokungafani ne-HRT, nangona kunjalo, u-Evista unempembelelo ye-anti-estrogen kwiiseli zebele kwaye kunokunciphisa umngcipheko wokuvelisa umdlavuza webele. Ngelixa i-SERMS ingabinyuli ukuxinwa kweethambo kwinqanaba le-bisphosphonate, banokunciphisa umngcipheko weemfucuza zengxantyambo (kodwa kungabikho i-fractures) kunye nokuphucula uxinzelelo lweethambo.
Imiphumo emibi ye-SERMS ibandakanya ukutshisa okutshisa, ama-aches ahlangeneyo kunye nokujuluka. Basenokunyusa umngcipheko weengxube zegazi ezifana ne-vein thrombosis, i-pulmonary emboli (i-blood clots emlenzeni oyeke ukuhamba uye emiphakeni), kunye ne-retinal vein thrombosis.
IHormone Replacement Therapy (HRT)
Ngoxa i-hormone yonyango yokutshintshwa (HRT) yayikhe yabizwa ngokuba yicala elimangalisayo lokuthintela i-osteoporosis kwabasetyhini, ayisayi kuvunywa kule nqondiso. Ukongezelela, uphando olufumana ingozi yomhlaza wesifuba, isifo senhliziyo kunye nokubetha kwabasetyhini abathatha i-HRT kuye kwabangela ukuba la mayeza asetyenziswa kangangoko.
Ngokuqinisekileyo, kusekho abantu abasebenzisa i-HRT kwimpawu ze-menopausal, kwaye iyakwazi ukusebenza kakuhle kwezi zimpawu. Esinye isizathu esibalulekileyo sokulahleka kwethambo kumabhinqa angumama we-menopausal kukunciphisa inani le- estrogen eliveliswa ngumzimba. Kunengqiqo ke ukuba i-hormone yonyango yokuguqula (HRT) iya kunceda ukunciphisa ukulahleka kwethambo.
Njengoko nawaphi na amayeza, kufuneka uqikelele ingozi kunye neenzuzo zaliphi na iziyeza ozisebenzisayo. Kubasetyhini abasebatyhini abaye baqeda ukutshatyalaliswa kwamadoda kwaye banenkinga yokutshisa ubomi, i-HRT inokuba yinto efanelekileyo. Sekunjalo, nangona kuleso sihlalo, injongo yonyango kunye ne-HRT ayifanele iyancitshiswe kwi-risk of osteoporosis.
Denosumab (Prolia no Xgeva)
Isetyenziswe rhoqo ngabantu abanomdlavuza, i-denosumab yi-antioclonal antibody ekhusela ukubunjwa kwe-osteoclasts, iiseli ezibangelwa ukuphuka kwethambo.
Kwabesetyhini abanesifo se-aromatase inhibitors (izidakamizwa zesifo somhlaza we-postmenopausal) ezenza umngcipheko we-osteoporosis, okanye amadoda aphethwe yicrothate ye-prostate yomhlaza (androgen). I-Denosumab isetyenziselwa abantu abanaluphi na uhlobo lomhlaza oye wasasazeka emathanjeni abo ukunciphisa umngcipheko weentlobo.
Ukunikezelwa ngumjovo, i-denosumab ineprofayili yecala efana ne-bisphosphonates kwaye inokunyusa ingozi ye-osteonecrosis yomhlathi.
I-Calcitonin (i-Miacalcin, i-Fortical, iCalcimar)
I-Calcitonin yinguqu eyenziwe ngumntu we-hormone emizimbeni yethu elawula i-bone metabolism kwaye inokunceda ukutshintsha umlinganiselo apho umzimba uphinde usebenzise amathambo. Itholakala zombini nje nge-spray spray kunye ne-injection kwaye inokunciphisa umngcipheko weemfucuza zomthunzi. I-Miacalcin, i-spray nasalfray, ngokukodwa, inokuba yinto ekhethekileyo kubafazi besimo se-postmenopausal abangakwazi ukunyamezela imiphumo emibi yezinye iyeza.
I-Parathyroid iHormone kunye neeDerivatives
I-Forteo (i-teriparatide) yinguqu eyenziwe ngumntu we-hormone yomzimba yendalo kwaye iqhelekileyo isetyenziselwa kuphela abantu abane-osteoporosis enamandla abasengozini enkulu yokuphuka. Yona yodwa imishanguzo enokunyusa umzimba ukuba ukhule ithambo elitsha. Ukusetyenziswa okwangoku kugqityiwe kwiminyaka emi-2 kuphela. I-Tymlos (i-abaloparatide) iyafana kwaye ingumxholo we-synthetic of portion of hormone ye-parathyroid.
Unyango lweziyobisi phantsi
Kukho ingxoxo malunga nokusetyenziswa kwamachiza ukunyanga i-osteopenia, kwaye abanye bathi i-osteopenia yinxalenye yendalo yokuguga. Sekunjalo siyazi ukuba abanye abantu baya kuba mngcipheko omkhulu wokubandezeleka kwezinto, kwaye yonke into eyahlukileyo ingathetha ukuba ishiywe ingaphathwa. Ukuba unayo i-osteopenia, wena kunye nogqirha wakho unokuqikelela ubunzima bakho beminyaka engama-10 ekuphuhliseni i-hip okanye ukuphazamiseka kwezihlunu ngokusebenzisa iitshathi kunye neetafile ezifumaneka kwi-World Health Organization okanye kwi-Osteoporosis Foundation.
Ukulawula i-Osteopenia kunye okanye ngaphandle kwezidakamizwa
Ingaba okanye ukhethe ukhethe ukusebenzisa imishanguzo ye-osteopenia, kukho izinto ongayenza ukuze unciphise umngcipheko weentsimbi . Ukususela ekuqinisekiseni ukuba izitebhisi zakho zikhululekile ukuba zihlale ezihlakaleni, kukho iindlela ezininzi ezinokuthi unciphise amathuba okuwa.
Ukufumana i-calcium eyanele kunye ne-vitamin D kubalulekile. Abantu abaninzi bafumana i-calcium eninzi ekudleni kwabo, kodwa i-vitamin D iyanzima ukuza, ngakumbi kwiindawo eziMntla. Thetha nogqirha wakho malunga nokujonga izinga lakho le-vitamin D (abaninzi abantu abanalo). Ukuba izinga lakho liphantsi okanye kwicandelo elincinane lecandelo eliqhelekileyo, buza malunga nokuba ungayifumani i-vitamin D3.
Ukuzivocavoca rhoqo kunye nokuyeka ukutshaya kubaluleke kakhulu ekuthintekeni kwe-osteoporosis.
ILizwi Elivela Kwonyango lwe-Osteopenia
Ngokungafani ne-osteoporosis, azikho izikhokelo ezicacileyo zokunyanga i-osteopenia, kwaye umntu ngamnye kufuneka ahlolisiswe ngokunyamekileyo ukuba anqume ukuba imithi ingaba yinzuzo. Enye ingqwalasela enkulu kukuba ngaba umntu kulindeleke ukuba aqhubekele ekubeni ne-osteoporosis okanye ingozi enkulu yokwahlukana kwemiphumo ngenxa yezinye iimeko zonyango.
Kukho amayeza amaninzi angasebenzayo ekunciphiseni ukulahlekelwa kwethambo, kodwa zonke ezi zize zengozi yemiphumo efanayo. Okwangoku, izidakamizwa kuphela ezivunyiwe kwi-osteopenia (ukukhusela i-osteoporosis) zi-Actonel no-Evista. Amanye amayeza, nangona kunjalo, unokuqwalaselwa ngokusekelwe kwiimeko ezithile zabantu.
Ukuba uye wafumanisa ukuba unesifo se-osteopenia unokuxoxa ngokucophelela nodokotela wakho. Thetha malunga noko kunokulindelwa kwiminyaka ezayo. Thetha ngomngcipheko weentlobo, kwaye yiyiphi intsingiselo ekuthethwa ngayo malunga nokuhamba kwakho nokuzimela. Emva koko uthethe ngemiphumo emibi yonyango nawuphi na unyango kwaye ulinganise ngawo nayiphi na inzuzo onokuyilungela. Kubalulekile ukuba ube ngummeli wakho ekunyamekeleni kwakho, ngokukodwa kwimiba enjengaleyo ekufuneka ukhetho lwezokwelapha lube lugcinwe ngabanye.
> Imithombo:
> Eriksen, E. Ukunyangwa kwe-Osteopenia. Iingxelo kwi-Endocrinology kunye neengxaki zeMetabolic . 2012. 13 (3): 209-223.
> Kasper, uDennis L .., u-Anthony S. Fauci, noStephen L .. Hauser. Iinqununu zeHarrison zeMithi yoPhakathi. ENew York: imfundo kaMc Graw Hill, 2015. Print.
> Rosen, H. Imfundo yesifo: Ukuthintela i-osteoporosis kunye nonyango (Ngaphandle kweZiseko). UpToDate . Ukuhlaziywa 03/26/17.