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El uso clínico de la densitometría ósea: revisión científica
Steven R Cummings1, David Bates, Dennis M Black
1The UCSF Coordinating Center, University of California, San Francisco, USA. scummings@psg.ucsf.edu
JAMA
|October 17, 2002
Resumen
La prueba de densidad mineral ósea (DMO) predice eficazmente el riesgo de fractura en mujeres blancas posmenopáusicas. Las directrices sugieren exámenes de detección de DMO para mujeres blancas mayores de 65 años y mujeres más jóvenes seleccionadas.
Área de la Ciencia:
- La investigación de la osteoporosis en las investigaciones de la osteoporosis.
- Diagnóstico de la salud ósea diagnósticos de la salud ósea.
- La epidemiología clínica es la epidemiología clínica.
Sus antecedentes:
- La osteoporosis conduce a una morbilidad significativa y a costos de atención médica.
- La densitometría ósea es crucial para diagnosticar la osteoporosis y guiar el tratamiento.
- La densitometría mineral ósea (DMO) se utiliza cada vez más en la práctica clínica.
Objetivo del estudio:
- Evaluar la utilidad clínica de varias aplicaciones de densitometría ósea.
- Revisar la evidencia existente sobre el valor diagnóstico y pronóstico de las mediciones de DMO.
Principales métodos:
- Una búsqueda exhaustiva de MEDLINE actualizó los metanálisis anteriores sobre DMO y riesgo de fractura.
- Los datos del Estudio de Fracturas Osteoporóticas se utilizaron para evaluar el riesgo de fractura en mujeres posmenopáusicas.
- Se hizo hincapié en los metanálisis y las revisiones sistemáticas cuando estuvieran disponibles.
Principales resultados:
- La DMO, particularmente la DMO de la cadera, es un fuerte predictor del riesgo de fractura en mujeres blancas posmenopáusicas cuando se combina con la edad.
- Los beneficios del tratamiento para la prevención de fracturas son más pronunciados en mujeres con osteoporosis.
- Existen datos insuficientes para interpretar de manera confiable la DMO para el riesgo de fractura en hombres y mujeres no blancas.
Conclusiones:
- Las directrices recomiendan la medición de la DMO para las mujeres blancas mayores de 65 años y el cribado selectivo para las mujeres posmenopáusicas más jóvenes.
- Se necesita más investigación para las aplicaciones de DMO en hombres y mujeres no blancas.
- Las áreas potenciales para más estudios incluyen el monitoreo de la DMO durante el tratamiento y la identificación de las causas secundarias de la osteoporosis.
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