绝经后健康和骨质疏松症的顺序管理:最新情况
Joaquin Calaf-Alsina1, Antonio Cano2, Núria Guañabens3
1Obstetrics and Gynaecology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma Barcelona, Sant Antoni Maria Claret 167, 08025 Barcelona, Spain.
Maturitas
|September 22, 2023
概括
本综述概述了绝经后妇女的顺序性骨质疏松症管理,强调治疗选择的年龄越来越大的骨折风险. 综合护理模式指导治疗决策,以实现最佳的骨健康和骨折预防.
科学领域:
- 内分泌学 在内分泌学.
- 老年学是一门学科.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 由于增加了预期寿命,女性大约三分之一的生命都处于低雌激素状态.
- 在此期间,骨健康受到衰老和累积风险因素的影响.
- 骨质疏松症的管理需要一个战略性的,顺序的方法.
研究的目的:
- 在整合性护理模式中总结连续性骨质疏松症管理策略.
- 为医生提供治疗决策工具,以治疗绝经后骨质疏松症.
- 优化骨健康,降低老年妇女骨折风险.
主要方法:
- 对治疗骨质疏松症的药理学药物的现有证据的审查.
- 基于骨折风险的顺序治疗方法的分析.
- 考虑激素治疗,选择性雌激素受体调节剂,抗吸收剂和合成代谢剂.
主要成果:
- 药物药剂的选择应基于骨折风险,而不仅仅是年龄.
- 激素治疗和选择性雌激素受体调节剂被建议用于早期绝经后.
- 当激素治疗不可行时,抗吸收剂是第一线药物,药物选择受到患者因素的影响.
- 对于高风险患者,建议采用"安纳波利克首先"的方法,其次是抗吸收药.
- 长期的随访和治疗对于持续的骨折预防至关重要.
结论:
- 在绝经后的骨质疏松症中,整合性,顺序性管理策略是必不可少的.
- 治疗决策应根据骨折风险和患者特征进行个性化.
- 无限期的随访和治疗是保持骨健康和预防骨折所必需的.
相关概念视频
Menopause
191
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
191
Bone Remodeling
38.4K
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.
38.4K
Bone Disorders
3.6K
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...
3.6K
Role of Vitamins in Maintaining Bone Health
3.4K
The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
3.4K
Osteoclasts in Bone Remodeling
3.0K
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...
3.0K
Hormonal Control of the Ovarian Cycle
555
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
555


