骨密度計の臨床用途:科学的なレビュー
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
まとめ
骨のミネラル密度 (BMD) 検査は,閉経後の白人女性の骨折リスクを効果的に予測します. ガイドラインでは,65歳以上の白人女性および選択された若い女性のBMDスクリーニングを推奨しています.
科学分野:
- 骨粗鬆症の研究について
- 骨の健康診断 骨の健康診断
- 臨床流行病学 臨床流行病学とは
背景:
- 骨粗鬆症は,著しい罹病率と医療費につながります.
- 骨密度測定は,骨粗鬆症の診断と治療のガイドに不可欠です.
- 骨鉱物密度計 (BMD) は,臨床実務でますます利用されています.
研究 の 目的:
- 様々な骨密度測定アプリケーションの臨床的有用性を評価する.
- BMD測定の診断および予後値に関する既存の証拠をレビューする.
主な方法:
- 総合的なMEDLINE検索により,前回の骨髄損傷と骨折リスクに関するメタ分析が更新されました.
- オステオポロティック骨折研究からのデータは,閉経後の女性の骨折リスクを評価するために使用されました.
- メタアナリシスや,可能な限り,体系的なレビューを重視した.
主要な成果:
- BMD,特に股関節のBMDは,年齢と組み合わせると,閉経後の白人女性の骨折リスクの強い予測因子です.
- 骨折の予防のための治療効果は,骨粗鬆症の女性ではより顕著です.
- 男性と非白人女性の骨折リスクに関するBMDを信頼性のある解釈するために十分なデータが存在しない.
結論:
- ガイドラインは,65歳以上の白人女性のBMD測定と,更年期後の若い女性の選択的スクリーニングを推奨しています.
- 男性と非白人の女性におけるBMDの応用については,さらなる研究が必要である.
- 治療中のBMDモニタリングと,二次性骨粗鬆症の原因を特定するなど,さらなる研究の可能性のある分野です.
関連する概念動画
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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...