Osteoporosis – the vaccine you didn’t know and the prevalence in China

October 20th is World Osteoporosis Day, an event started in the UK and sponsored by the International Osteoporosis Foundation (IOF), said When it comes to osteoporosis, many people will think of the elderly in their own homes, so today we will talk about osteoporosis and vaccines.

One. Osteoporosis vaccine

Some people think that osteoporosis is not as contagious as the new crown and flu, and there will be a vaccine?

It is certain that with the development of science and technology, osteoporosis will also have vaccines that can be prevented, just as people can make “Chang’e flying to the moon” a reality, let’s see See the information below.

In the theoretical basis, it was found that the receptor activator ( RANKL), is a key factor in bone loss in patients with osteoporosis. Therefore, Swiss scientists have developed a therapeutic vaccine based on virus-like particle technology prepared using Qβ bacteriophage cross-linked with TRANCE/RANKL as an antigen, and the vaccine has been injected into mice with positive results. [1].

After injecting the test mice with the vaccine, it was found that the vaccine can make the mice produce high levels of specific antibodies and effectively inhibit bone loss even without any adjuvant. And there were no visible side effects. Unfortunately, it has been nearly 20 years since the publication of this osteoporosis vaccine research, and there has been no very noteworthy progress in the follow-up.

However, in a domestic scientific and technological achievements registration form published in 2019 [2], it can be seen that some domestic researchers have adopted this kind of thinking, using the RANKL mutant NM29 to carry out similar experiments. Research is currently in a very basic research direction and has not yet advanced to clinical practice. However, since there is hope, it is worth keeping an eye on it, and maybe there is some surprising information at any time?

Second, the harm of osteoporosis

The dangers of osteoporosis are more than simply “loose bones.”

When bone is lost, the bones tend to become brittle, which means that the likelihood of fractures increases, making fractures more common [3]. Studies have shown that almost one in two women and one in five men will experience a fragility fracture in the rest of their lives after the age of 50 [4]. In addition, vertebral and hip fractures lead to increased morbidity and mortality, as well as significant medical costs [5].

In addition to fractures, other possible conditions may include changes in height, posture, etc. [6], as well as shortness of breath, back pain, etc. [7], like many Elderly people often say that they “get older and shorter”.

Therefore, when the elderly at home or around them often feel that they are getting more and more “shrinking”, they often need to pay more attention to their other physical conditions.

Three reasons for fractures and porosis

Scanning of human bones thousands of years ago found that many women were already affected by osteoporosis, and that increasing age increased the risk of osteoporosis, and There is a relationship between female menopause and osteoporosis, and it is easy to think of various risk factors leading to osteoporosis. The main reasons are as follows:

01Age accompanies hormonal changes[8]: The main cause of increased osteoporosis risk is age, although this effect affects people of all genders, especially Menopause or oophorectomy in women is also an age-related factor (but in contrast, the decrease in testosterone in men with age has little effect).

02 Race, genetics, fracture history, stature [9-12]. : These factors are all related to the risk of osteoporosis, and these conditions are not fixed by external factors.

03 Variables [13-16]. : In addition to the above fixed factors, there are also some variable factors, including smoking, alcoholism, vitamin D deficiency, insufficient physical activity, malnutrition, etc. It is even found that underweight people are more prone to osteoporosis, while overweight people are less likely to have osteoporosis. .

It is worth noting that these variables can be changed in many ways, or even non-existent.

IV. History of Osteoporosis Research

Osteoporosis is defined as a disease in recent decades, and in fact patients with osteoporosis have existed for thousands of years before this [17] .

By measuring the bone density of bone samples (that is, turning out human bones thousands of years ago to measure), osteoporosis has affected many people thousands of years ago, Including women in Egypt, women in the Bronze Age in Austria, women in the Neolithic Age in Portugal, women in the New Age in Turkey, women in ancient Africa Nubia, etc.

Thousands of years later, in the 18th century, the process of bone remodeling was recognized by the Scottish surgeon John Hunter, and later in the 19th century by Astley Cooper ( Astley Paston Cooper found that decreased bone density with age increases fracture risk. It was not until 1835 that the term “osteoporosis” was coined by the French physician Jean Lobstein, and at that time it could also be called “porous bone”.

The treatment options for osteoporosis are starting to become clear as American medical scientist Fuller Albright reveals the effects of female menopause and estrogen on bones , until now there are multiple ways to prevent and treat osteoporosis.

Interestingly, after the term osteoporosis came into existence, the term was incorrectly applied to bones affected by osteomyelitis, only to be corrected later.

Osteoporosis is now defined as the presence of a fracture resulting from a fall from standing height or lower in the absence of high trauma, a “fragility fracture” Diagnosed with osteoporosis. In layman’s terms, osteoporosis is when the bones become loose and become more brittle and break easily.

V. Osteoporosis in my country

From a global perspective, it is difficult to accurately diagnose osteoporosis. For example, developed countries have found that 2% to 8% of men and 9% of % to 38% of women are affected [18]; in fact, in my country, according to the data released by the Chinese Center for Disease Control and Prevention in 2021 [19], the prevalence of osteoporosis is not low.

According to a cross-sectional study published in 2021 in collaboration with the Chinese Center for Disease Control and Prevention, among the 20416 study subjects, osteoporosis in adults aged 40 and over was The prevalence of the disease was 5.0% and 20.6% in males and females, respectively.

However, it is very interesting to note that although the prevalence of osteoporosis in men is significantly lower than that in women, the prevalence of vertebral fractures is similar in men and women, respectively. were 10.5% and 9.7%.

Similar to studies in other countries, the prevalence of osteoporosis in our country also increases with age, and for the elderly, falls after osteoporosis also There will be other dangers along with it – perhaps you’ve heard the term “last fall.”

The researchers therefore also mentioned that clinical and public health efforts to reduce the fracture burden should treat men and women equally in urban and rural areas and should focus on screening and prevention of vertebral fractures.

Six, daily prevention of osteoporosis

The causes of osteoporosis have fixed and variable factors, and the risk of developing osteoporosis can be reduced by the following methods [20,21].

01Tobacco and alcohol control: For people who smoke and drink alcohol, controlling the amount of smoking and drinking, or even quitting smoking and drinking is very good to reduce the risk of osteoporosis The way. It’s easy to say, but getting people with a history of smoking and drinking to do it is really difficult, both men and women.

02 Exercise and nutrition: Moderate exercise (more than 30 minutes of weight-bearing exercise per day), maintaining adequate nutrition (including adequate calcium and vitamin D), and daily fall prevention are both A healthy lifestyle is also an effective way to avoid osteoporosis.

03 Calcium and vitamin D supplementation: For calcium and vitamin D supplementation (not just children who need to supplement these nutrients), it should be reminded that, Not everyone has to take supplements if they have nothing to do, but if they need supplements (such as postmenopausal women, etc.), they should consider whether they need supplements according to their diet.

Reminder: Those who recommend everyone to take supplements are basically selling health products, don’t be deceived.

Review: Guo Yuchai


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