[骨质疏松症 - - 新指南在实践中的影响]
Heide Siggelkow1,2, Friederike Thomasius3
1Zentrum für Endokrinologie, Osteologie, Rheumatologie, Nuklearmedizin und Humangenetik, MVZ Endokrinologikum Göttingen, Göttingen.
Deutsche medizinische Wochenschrift (1946)
|May 23, 2024
概括
2023年骨质疏松指南更新了绝经后女性和男性骨折风险评估和治疗门. 它强调个性化的护理,包括跌倒风险和新的治疗方法,以更好地预防骨折.
科学领域:
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
- 类风湿病学 类风湿病学
背景情况:
- 骨质疏松症管理指南需要定期更新以反映当前的证据.
- 以前的指导方针对诊断和治疗开始有特定的骨折风险值.
- 个性化风险评估对于有效的骨质疏松症护理至关重要.
研究的目的:
- 概述2023年修订的骨质疏松症预防,诊断和治疗指南中的关键变化.
- 要突出骨密度测量和骨折风险评估的最新指示.
- 详细说明基于个体骨折风险的新治疗建议.
主要方法:
- 修订2023年骨质疏松症管理指南.
- 包括33个骨折预测风险因素,以及年龄和性别.
- 强调跌倒风险评估及其与肌肉训练和蛋白质摄入量建议的整合.
- 更新了启动骨密度诊断和治疗值的标准.
- 包括治疗指示的3年骨折风险计算.
主要成果:
- 测量骨密度的适应症不再仅仅依赖于>20%的10年骨折风险.
- 现在,根据风险因素概况,对绝经后的女性和50岁以上的男性进行诊断.
- 治疗的开始是以使用风险计算器进行3年骨折风险评估为指导.
- 对于非常高的骨折风险 (≥10%超过3年) 建议使用合成代谢疗法 (teriparatide,romosozumab).
结论:
- 修订后的指导方针促进了早期和更个性化的骨质疏松症诊断和治疗.
- 更新的风险评估工具和治疗值旨在优化骨折预防.
- 类固醇药物优先用于高危人群,提供更快的骨折风险降低.
更多相关视频
07:12Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model
Published on: September 28, 2017
8.2K
07:56Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
17.5K
相关概念视频
01:29Bone Disorders
3.5K
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...
3.5K
01:31Osteoclasts in Bone Remodeling
2.9K
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...
2.9K
01:40Bone Remodeling
38.3K
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.
38.3K
01:25Role of Vitamins in Maintaining Bone Health
3.3K
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...
3.3K
01:17Hormones and Bone Tissue
2.7K
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...
2.7K
01:31Essential Minerals for Bone Health
3.9K
The minerals contained in all of the food we consume are essential for our organ systems. However, certain essential minerals, such as calcium, phosphorus, magnesium, manganese, and fluoride, largely affect bone health.
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
3.9K