骨密度计的临床应用:科学综述
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
概括
骨矿物质密度 (BMD) 测试有效预测绝经后白人女性骨折风险. 指导方针建议65岁以上的白人女性和选定的年轻女性进行骨质疏松症查.
科学领域:
- 骨质疏松症的研究研究.
- 骨健康诊断 诊断 骨健康诊断
- 临床流行病学临床流行病学
背景情况:
- 骨质疏松症导致严重的发病率和医疗保健费用.
- 骨密度计对于诊断骨质疏松症和指导治疗至关重要.
- 骨矿物密度计 (BMD) 在临床实践中越来越多地使用.
研究的目的:
- 评估各种骨密度计应用的临床实用性.
- 审查 BMD 测量的诊断和预后价值的现有证据.
主要方法:
- 一个全面的MEDLINE搜索更新了以前关于骨损伤和骨折风险的元分析.
- 来自骨质疏松性骨折研究的数据被用来评估绝经后妇女的骨折风险.
- 重点放在元分析和系统审查,如果有.
主要成果:
- 骨髓质量,特别是部骨髓质量,与年龄相结合,是绝经后白人女性骨折风险的强有力的预测因素.
- 对骨折预防的治疗益处在患有骨质疏松症的女性中更为明显.
- 目前还没有足够的数据可靠地解释男性和非白人女性骨折风险的骨质量.
结论:
- 指导方针建议65岁以上的白人妇女测量BMD,年轻的绝经后妇女进行选择性查.
- 对男性和非白人女性的BMD应用需要进一步的研究.
- 进一步研究的潜在领域包括治疗期间的骨质疏松症监测和识别二次骨质疏松症原因.
相关概念视频
Bone Structure
Within the skeletal system, the structure of a bone, or osseous tissue, can be exemplified in a long bone, like the femur, where there are two types of osseous tissue: cortical and cancellous.
Bone Remodeling
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
Osteoclasts in Bone Remodeling
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...
Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Hormones and Bone Tissue
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Bone Remodeling and Repair
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...


