{"id":28328,"date":"2017-05-28T23:23:55","date_gmt":"2017-05-28T21:23:55","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=28328"},"modified":"2017-05-28T23:24:03","modified_gmt":"2017-05-28T21:24:03","slug":"osteoporoza-tichy-zlodej-21-stoleti","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=28328","title":{"rendered":"Osteopor\u00f3za \u2013 tich\u00fd zlod\u011bj 21. stolet\u00ed"},"content":{"rendered":"

P\u0159ibli\u017en\u011b u jedn\u00e9 ze t\u0159\u00ed \u017een a jednoho z p\u011bti mu\u017e\u016f ve v\u011bku nad 50 let dojde ke zlomenin\u011b kosti z d\u016fvodu osteopor\u00f3zy. P\u0159itom v\u011bt\u0161ina pacient\u016f nen\u00ed na osteopor\u00f3zu vy\u0161et\u0159ena a l\u00e9\u010dena. Je t\u0159eba zlomenin\u00e1m p\u0159edch\u00e1zet, ne se sna\u017eit hasit n\u00e1sledky, kter\u00e9 \u010dasto u\u017e \u0159e\u0161it nelze. Do jednoho roku po zlomenin\u011b ky\u010dle toti\u017e um\u00edr\u00e1 20 \u2013 24 % pacient\u016f.<\/strong><\/p>\n

Celo\u017eivotn\u011b v kostech cel\u00e9ho t\u011bla doch\u00e1z\u00ed k odbour\u00e1v\u00e1n\u00ed star\u00e9 po\u0161kozen\u00e9 kosti a tvorb\u011b nov\u00e9. Do 25. \u2013 30. roku v\u011bku p\u0159eva\u017euje jejich tvorba. Maximum kostn\u00ed hmoty, hovo\u0159\u00edme o takzvan\u00e9 vrcholov\u00e9 denzit\u011b, m\u00e1 na\u0161e kostra kolem 30. roku v\u011bku, pot\u00e9 za\u010d\u00edn\u00e1 p\u0159eva\u017eovat proces odbour\u00e1v\u00e1n\u00ed (osteoresorpce). Kosti postupn\u011b \u0159\u00eddnou, m\u011bn\u00ed se jejich struktura, st\u00e1vaj\u00ed se k\u0159eh\u010d\u00edmi, sni\u017euje se pru\u017enost a pevnost skeletu. Nejdramati\u010dt\u011bji se za\u010dne struktura kost\u00ed m\u011bnit u \u017een po menopauze, kdy kv\u016fli \u00fabytku hormonu estrogenu do p\u011bti let po menopauze mohou ztratit a\u017e 5 % celkov\u00e9 kostn\u00ed hmoty. U mu\u017e\u016f se v\u00fdskyt osteopor\u00f3zy objevuje ve vy\u0161\u0161\u00edm v\u011bku, nen\u00ed tak \u010dast\u00fd, ale ani oni nejsou bez rizika. Podle statistik se s n\u00ed pot\u00fdk\u00e1 ka\u017ed\u00fd 5. mu\u017e po pades\u00e1t\u00e9m roce \u017eivota. Z\u00e1rove\u0148 je l\u00e9\u010dba osteopor\u00f3zy u mu\u017e\u016f obt\u00ed\u017en\u011bji dostupn\u00e1. Ne u v\u0161ech l\u00e9k\u016f souhlasily regula\u010dn\u00ed org\u00e1ny \u010cR s jejich pou\u017e\u00edv\u00e1n\u00edm v praxi pro mu\u017esk\u00e9 pacienty. P\u0159itom se \u010dasto jedn\u00e1 o nemocn\u00e9, kte\u0159\u00ed maj\u00ed tzv. sekund\u00e1rn\u00ed osteopor\u00f3zu, tedy doprov\u00e1zej\u00edc\u00ed jin\u00e9 choroby, mnohdy n\u00e1dorov\u00e9 onemocn\u011bn\u00ed prostaty. Zlomeninu souvisej\u00edc\u00ed s \u00fabytkem miner\u00e1lu utrp\u00ed v pr\u016fb\u011bhu \u017eivota 30 \u2013 50 % \u017een a 15 \u2013 30 % mu\u017e\u016f. 1<\/p>\n

Osteopor\u00f3za prim\u00e1rn\u00ed a sekund\u00e1rn\u00ed<\/p>\n

Jako osteopor\u00f3zu tedy ozna\u010dujeme \u00fabytek miner\u00e1lu spojen\u00fd se \u0161patnou kvalitou kosti, vedouc\u00ed ke zv\u00fd\u0161en\u00e9mu riziku zlomeniny i po mal\u00e9m podn\u011btu. Tato forma se naz\u00fdv\u00e1 prim\u00e1rn\u00ed osteopor\u00f3za, souvis\u00ed se st\u00e1rnut\u00edm organismu a mezi populac\u00ed v\u00fdrazn\u011b p\u0159eva\u017euje. Velmi \u010dasto se vyskytuje i sekund\u00e1rn\u00ed osteopor\u00f3za zp\u016fsoben\u00e1 jin\u00fdm prob\u00edhaj\u00edc\u00edm onemocn\u011bn\u00edm (nap\u0159\u00edklad cukrovkou, chronick\u00fdm onemocn\u011bn\u00edm jater a ledvin, zv\u00fd\u0161enou \u010dinnost\u00ed \u0161t\u00edtn\u00e9 \u017el\u00e1zy, zhoubn\u00fdm bujen\u00edm, chronick\u00fdmi z\u00e1n\u011bty pohybov\u00e9 apar\u00e1tu\u2026), pod\u00e1v\u00e1n\u00edm n\u011bkter\u00fdch l\u00e9k\u016f, nadu\u017e\u00edv\u00e1n\u00edm alkoholu, n\u00e1vykov\u00fdch l\u00e1tek nebo nikotinismu.<\/p>\n

D\u016fle\u017eit\u00e1 je prevence a sledov\u00e1n\u00ed varovn\u00fdch sign\u00e1l\u016f vlastn\u00edho t\u011bla<\/p>\n

Prevence \u00fabytku kostn\u00ed d\u0159en\u011b je prvn\u00ed a nej\u00fa\u010dinn\u011bj\u0161\u00ed ochranou p\u0159ed vznikem osteopor\u00f3zy. To znamen\u00e1 kvalitn\u00ed stravu bohatou na b\u00edlkoviny, v\u00e1pn\u00edk, vitamin D (pom\u00e1h\u00e1 vst\u0159eb\u00e1v\u00e1n\u00ed v\u00e1pn\u00edku do organismu) spojenou s p\u0159im\u011b\u0159en\u00fdm pobytem na slunci a dal\u0161\u00ed vitaminy. Do pov\u011bdom\u00ed ve\u0159ejnosti se dost\u00e1v\u00e1 i pot\u0159ebn\u00fd p\u0159\u00edjem vitaminu K2, kter\u00fd je nutn\u00fd pro zabudov\u00e1n\u00ed v\u00e1pn\u00edku do<\/p>\n

kosti a ne do jin\u00fdch tk\u00e1n\u00ed. Nezbytn\u00e9 jsou i dal\u0161\u00ed miner\u00e1ly a stopov\u00e9 prvky a tak\u00e9 vhodn\u00fd a dostate\u010dn\u00fd pohyb. Na to je t\u0159eba myslet u\u017e v prvn\u00edch letech \u017eivota d\u011bt\u00ed a sna\u017eit se jim nastavit spr\u00e1vn\u00e9 \u017eivotn\u00ed n\u00e1vyky.<\/p>\n

P\u0159\u00edznaky ji\u017e vznikl\u00e9 osteopor\u00f3zy b\u00fdvaj\u00ed dlouho nen\u00e1padn\u00e9, nemoc se n\u011bkdy zjist\u00ed n\u00e1hodn\u011b (nap\u0159\u00edklad p\u0159i rentgenov\u00e9m vy\u0161et\u0159en\u00ed, ov\u0161em pozor: rentgen odhal\u00ed nemoc a\u017e v situaci, kdy je \u00fabytek kostn\u00ed hmoty t\u0159etina a v\u00edce z celkov\u00e9ho mno\u017estv\u00ed) nebo se schov\u00e1vaj\u00ed za b\u011b\u017en\u00e9 bolesti v z\u00e1dech.<\/p>\n

Nej\u010dast\u011bj\u0161\u00edm projevem je zlomenina po mal\u00e9m podn\u011btu. Typick\u00e9 jsou zlomeniny p\u0159edlokt\u00ed, obratl\u016f ve st\u0159edu hrudn\u00ed nebo bedern\u00ed \u010d\u00e1sti p\u00e1te\u0159e a nejz\u00e1va\u017en\u011bj\u0161\u00ed je zlomenina kr\u010dku stehenn\u00ed kosti. \u201eVarovn\u00fdmi sign\u00e1ly, kter\u00e9 by lid\u00e9 nem\u011bli podce\u0148ovat, jsou nap\u0159\u00edklad genetick\u00e9 dispozice. Pokud m\u011bl n\u011bkdo z rodi\u010d\u016f osteopor\u00f3zu, respektive zlomeninu po pades\u00e1t\u00e9m roce v\u011bku, je vysok\u00e1 pravd\u011bpodobnost, \u017ee potomek onemocn\u00ed tak\u00e9,\u201c upozor\u0148uje MUDr. Marie L\u00e1dov\u00e1, specialistka z osteologick\u00e9 ambulance v \u010cesk\u00fdch Bud\u011bjovic\u00edch. \u201eMezi dal\u0161\u00ed rizika pat\u0159\u00ed p\u0159ed\u010dasn\u00e1 menopauza u \u017een p\u0159ed 45. rokem v\u011bku, poruchy menstrua\u010dn\u00edho cyklu, vlastn\u00ed zlomenina p\u0159ed pades\u00e1t\u00fdm rokem v\u011bku, b\u00edl\u00e1 rasa, sn\u00ed\u017een\u00ed hladiny estrogen\u016f i u mu\u017e\u016f a \u0159ada onemocn\u011bn\u00ed,\u201c vypo\u010d\u00edt\u00e1v\u00e1 MUDr. L\u00e1dov\u00e1.<\/p>\n

S\u00e1hn\u011bte si do sv\u011bdom\u00ed<\/p>\n

Na druhou stranu \u0159adu faktor\u016f, kter\u00e9 vznik nemoci potencuj\u00ed, lze ovlivnit. Riziko zvy\u0161uje nedostate\u010dn\u00e1 fyzick\u00e1 z\u00e1t\u011b\u017e (dlouh\u00e9 sezen\u00ed u po\u010d\u00edta\u010de, nepravideln\u00fd nebo \u017e\u00e1dn\u00fd sport, u nemocn\u00fdch osob dlouhodob\u00e9 upout\u00e1n\u00ed na l\u016f\u017eko), neplnohodnotn\u00e1 v\u00fd\u017eiva (nedostate\u010dn\u00fd p\u0159\u00edsun v\u00e1pn\u00edku a vitaminu D, nedostatek kvalitn\u00edch b\u00edlkovin, n\u00edzk\u00fd BMI \u2013 body mass index), kou\u0159en\u00ed, nadm\u011brn\u00e1 konzumace alkoholu a k\u00e1vy, dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed n\u011bkter\u00fdch l\u00e9k\u016f (kortikosteroidy, l\u00e9ky na \u0159ed\u011bn\u00ed krve, antiepileptika).<\/p>\n

Upozorn\u011bn\u00edm na nemoc mohou b\u00fdt tup\u00e9, neur\u010dit\u00e9 bolesti v z\u00e1dech p\u0159i del\u0161\u00edm sezen\u00ed, st\u00e1n\u00ed i b\u011b\u017en\u00fdch denn\u00edch \u010dinnostech, pokles t\u011blesn\u00e9 v\u00fd\u0161ky (a\u017e o 3 centimetry v produktivn\u00edm v\u011bku), zakulacen\u00ed zad, p\u0159edsunut\u00e1 hlava p\u0159ed t\u011blo, hrb, abnorm\u00e1ln\u00ed zak\u0159iven\u00ed p\u00e1te\u0159e (hrb v oblasti hrudn\u00ed p\u00e1te\u0159e), zhor\u0161en\u00ed pohyblivosti, povolen\u00e9 b\u0159icho. Ka\u017ed\u00fd jednotliv\u00fd sign\u00e1l by m\u011bl v\u00e9st k n\u00e1v\u0161t\u011bv\u011b praktick\u00e9ho l\u00e9ka\u0159e.<\/p>\n

Zapojte se aktivn\u011b do boje o sv\u00e9 kosti<\/p>\n

Sou\u010dasn\u00fd stav prevence rozhodn\u011b nen\u00ed uspokojiv\u00fd. S osteopor\u00f3zou se v \u010cesk\u00e9 republice l\u00e9\u010d\u00ed jen 24 % \u017een a 12 % mu\u017e\u016f.2 P\u0159itom sta\u010d\u00ed nav\u0161t\u00edvit sv\u00e9ho praktick\u00e9ho l\u00e9ka\u0159e nebo gynekologa, bu\u010f p\u0159i pozitivn\u00ed rodinn\u00e9 anamn\u00e9ze, nebo zji\u0161t\u011bn\u00ed n\u011bkter\u00e9ho z varovn\u00fdch p\u0159\u00edznak\u016f. Ten doporu\u010d\u00ed dal\u0161\u00ed vy\u0161et\u0159en\u00ed. \u201eTo mus\u00ed b\u00fdt komplexn\u00ed. Je nutn\u00e1 anamn\u00e9za se zam\u011b\u0159en\u00edm na v\u00fdskyt<\/p>\n

zlomenin v rodin\u011b, laboratorn\u00ed vy\u0161et\u0159en\u00ed a zcela bezbolestn\u00e9 denzitometrick\u00e9 vy\u0161et\u0159en\u00ed. Denzitometry b\u00fdvaj\u00ed v\u011bt\u0161inou sou\u010d\u00e1st\u00ed osteologick\u00fdch ambulanc\u00ed a osteocenter. Na cel\u00e9m sv\u011bt\u011b se vy\u0161et\u0159uj\u00ed domluven\u00e9 lokality \u2013 bedern\u00ed p\u00e1te\u0159, p\u0159edlokt\u00ed a horn\u00ed \u010d\u00e1st ky\u010deln\u00ed kosti na mno\u017estv\u00ed miner\u00e1l\u016f a hustotu kostn\u00ed tk\u00e1n\u011b,\u201c konstatuje MUDr. L\u00e1dov\u00e1. Pro posouzen\u00ed aktivity kosti se prov\u00e1d\u00ed laboratorn\u00ed vy\u0161et\u0159en\u00ed. Na z\u00e1klad\u011b v\u00fdsledku je doporu\u010dena l\u00e9\u010dba. \u201eTak\u00e9 mus\u00ed b\u00fdt komplexn\u00ed. Nefarmakologick\u00e1 spo\u010d\u00edv\u00e1 v \u00faprav\u011b j\u00eddeln\u00ed\u010dku (strava bohat\u00e1 na p\u0159\u00edjem v\u00e1pn\u00edku, vitaminu D, K2 a b\u00edlkovin) a zm\u011bny pohybov\u00e9 aktivity (omezen\u00ed vysed\u00e1v\u00e1n\u00ed u po\u010d\u00edta\u010de, naopak za\u0159azen\u00ed minim\u00e1ln\u011b 30 minut ch\u016fze denn\u011b, cvi\u010den\u00ed a dal\u0161\u00edch sport\u016f). U \u017een v p\u0159\u00edpad\u011b menopauzy je mo\u017en\u00e1 hormon\u00e1ln\u00ed substituce. V p\u0159\u00edpad\u011b, \u017ee l\u00e9\u010d\u00edme osteopor\u00f3zu se zlomeninou nebo rizikem vzniku zlomeniny, se pacient\u016fm pod\u00e1vaj\u00ed takzvan\u00e9 antiresorp\u010dn\u00ed l\u00e9ky, kter\u00e9 zabra\u0148uj\u00ed \u00fabytku kosti, p\u0159\u00edpadn\u011b zvy\u0161uj\u00ed obsah miner\u00e1lu v kosti,\u201c vypo\u010d\u00edt\u00e1v\u00e1 MUDr. L\u00e1dov\u00e1. \u201eRozhodn\u011b je t\u0159eba pravideln\u00e9 sledov\u00e1n\u00ed pacient\u016f a m\u011b\u0159en\u00ed stavu kostn\u00ed hmoty, abychom p\u0159ede\u0161li mnohdy fat\u00e1ln\u00edm n\u00e1sledk\u016fm osteopor\u00f3zy,\u201c dopl\u0148uje MUDr. L\u00e1dov\u00e1.<\/p>\n

J\u00eddeln\u00ed\u010dek a pohyb a\u017e na prvn\u00edm m\u00edst\u011b<\/p>\n

Z\u00e1kladem je \u00faprava \u017eivotn\u00edho stylu. Omezit potraviny, kter\u00e9 vst\u0159eb\u00e1v\u00e1n\u00ed v\u00e1pn\u00edku sni\u017euj\u00ed (sycen\u00e9 n\u00e1poje kolov\u00e9ho typu, \u010dern\u00e1 k\u00e1va). Naopak je t\u0159eba obohatit j\u00eddeln\u00ed\u010dek o ml\u00e9\u010dn\u00e9 v\u00fdrobky, listovou zeleninu, o\u0159echy, m\u00e1k, mo\u0159sk\u00e9 plody, ryby, lu\u0161t\u011bniny. Vhodn\u00e9 jsou tak\u00e9 rozinky, su\u0161en\u00e9 meru\u0148ky, \u0161vestky, f\u00edky, l\u00edskov\u00e9 o\u0159\u00ed\u0161ky i ovesn\u00e9 vlo\u010dky v bohat\u00e9 m\u00ed\u0159e.<\/p>\n

Pro udr\u017een\u00ed \u010di rozvoj kostn\u00ed hmoty v dosp\u011bl\u00e9m a star\u0161\u00edm v\u011bku je dobr\u00e9 prov\u00e1d\u011bt takovou aktivitu, p\u0159i n\u00ed\u017e p\u016fsob\u00ed na aktivovanou \u010d\u00e1st skeletu s\u00edla gravitace.3 Cvi\u010den\u00ed na podporu stability, silov\u00e1 cvi\u010den\u00ed s vahou vlastn\u00edho t\u011bla, nebo na posilovac\u00edch stroj\u00edch, protahovac\u00ed, relaxa\u010dn\u00ed, ale i dechov\u00e1 cvi\u010den\u00ed jsou nejenom prevenc\u00ed, ale i formou nemedikament\u00f3zn\u00ed l\u00e9\u010dby osteopor\u00f3zy.<\/p>\n

\u201eKdy\u017e p\u0159id\u00e1te 30 a\u017e 60 minut svi\u017en\u00e9 ch\u016fze denn\u011b a lehk\u00e9 posilovac\u00ed cvi\u010den\u00ed, a\u0165 u\u017e se z\u00e1t\u011b\u017e\u00ed \u010di bez n\u00ed, zv\u00fd\u0161\u00edte svalovou s\u00edlu, zlep\u0161\u00edte koordinaci pohyb\u016f, co\u017e p\u0159isp\u00edv\u00e1 tak\u00e9 k ochran\u011b p\u0159ed p\u00e1dy a tedy zlomeninami,\u201c vysv\u011btluje Mgr. Andrea Trajkova, vedouc\u00ed Rekondi\u010dn\u00edho centra V\u0160TJ Medicina, kde o pacienty s osteopor\u00f3zou pe\u010duj\u00ed.<\/p>\n

\u201eMezi vhodn\u00e9 fyzick\u00e9 aktivity pat\u0159\u00ed pilates, cvi\u010den\u00ed na m\u00ed\u010di, j\u00f3ga, tai-\u010di. Pro pohybov\u011b aktivn\u011bj\u0161\u00ed doporu\u010dujeme b\u011b\u017eky, nordic walking, cvi\u010den\u00ed zam\u011b\u0159en\u00e9 na pos\u00edlen\u00ed sval\u016f trupu, ale i balan\u010dn\u00ed cvi\u010den\u00ed, kter\u00e9 je d\u016fle\u017eit\u00e9 pro udr\u017een\u00ed rovnov\u00e1hy,\u201c dod\u00e1v\u00e1 Bc. Nicola D\u00f6rnerov\u00e1, instruktorka zdravotn\u011b orientovan\u00fdch lekc\u00ed Rekondi\u010dn\u00edho centra V\u0160TJ Medicina, kter\u00e1 sestavuje speci\u00e1ln\u00ed cviky pro prevenci i l\u00e9\u010dbu osteopor\u00f3zy. \u201eZcela nevhodn\u00e9 jsou \u0161vihov\u00e9 a prudk\u00e9<\/p>\n

pohyby (i t\u0159eba sek\u00e1n\u00ed kosou na zahrad\u011b), aktivity, kde hroz\u00ed p\u00e1d (kontaktn\u00ed sporty) a pohyby s ot\u0159esy (aerobik),\u201c dod\u00e1v\u00e1 Bc. D\u00f6rnerov\u00e1.<\/p>\n

\u201eVolba konkr\u00e9tn\u00ed fyzick\u00e9 aktivity ale tak\u00e9 z\u00e1vis\u00ed na celkov\u00e9m zdravotn\u00edm stavu jedince, zejm\u00e9na ve vy\u0161\u0161\u00edm v\u011bku. V praxi je mnohdy velmi t\u011b\u017ek\u00e9 motivovat k pravideln\u00e9mu cvi\u010den\u00ed, zejm\u00e9na star\u0161\u00ed lidi. Obavy a p\u0159edsudky v\u016f\u010di fyzick\u00e9mu cvi\u010den\u00ed \u010dasto pramen\u00ed u\u017e z jejich ml\u00e1d\u00ed. Je proto vhodn\u00e9 v\u00e9st k pohybu a dostate\u010dn\u00e9 fyzick\u00e9 aktivit\u011b zejm\u00e9na mlad\u0161\u00ed generaci. V\u010dasn\u00e1 edukace a popularizace pohybov\u00e9 aktivity vede ke sn\u00ed\u017een\u00ed incidence osteopor\u00f3zy v pozd\u011bj\u0161\u00edm v\u011bku,\u201c uzav\u00edr\u00e1 Mgr. Trajkova. <\/p>\n","protected":false},"excerpt":{"rendered":"

P\u0159ibli\u017en\u011b u jedn\u00e9 ze t\u0159\u00ed \u017een a jednoho z p\u011bti mu\u017e\u016f ve v\u011bku nad 50 let dojde ke zlomenin\u011b kosti z d\u016fvodu osteopor\u00f3zy. P\u0159itom v\u011bt\u0161ina […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":22868,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-28328","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28328","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28328"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28328\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/22868"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28328"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28328"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28328"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}