骨质疏松和骨折风险在炎症性类风湿性疾病患者中是多因素的
Frank Buttgereit1, Andriko Palmowski2,3, Milena Bond4
1Department of Rheumatology and Clinical Immunology at Charité - University Medicine Berlin, Berlin, Germany. frank.buttgereit@charite.de.
Nature reviews. Rheumatology
|June 3, 2024
概括
患有炎症性类风湿性疾病的患者面临更高的骨质疏松症风险,这是由于除了葡萄糖皮质激素之外的多因素原因. 一个全面的管理策略对于改善这些人的骨健康至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 内分泌学 在内分泌学.
- 整形外科 整形外科 整形外科
背景情况:
- 与一般人群相比,患有炎症性类风湿性和肌肉骨疾病 (iRMDs) 的患者患骨质疏松症和骨折的风险较高.
- 目前对iRMDs骨质疏松症的管理指南主要集中在葡萄糖皮质激素的使用上,经常忽视其他重要的贡献因素.
研究的目的:
- 要突出骨质疏松症在iRMDs中的多因素性质.
- 倡导一个更广泛的理解超越"糖皮质激素诱导的骨质疏松症".
- 强调需要采用多式联运管理方法.
主要方法:
- 对骨质疏松症风险和iRMDs中的保护因素的现有证据的审查.
- 对影响骨健康的疾病特异性和一般风险因素的分析.
- 评估影响骨折风险降低的因素.
主要成果:
- iRMDs中的骨质疏松受局部和全身炎症,疾病活动,残疾,营养不良,年龄和荷尔蒙变化的影响.
- 一般和iRMD特定的风险和保护因素表明",糖皮质激素诱导的骨质疏松症"是一种过度简单化.
- 身体活动,营养和维生素D补充等保护因素的实施不一致.
结论:
- iRMDs中的骨质疏松症是多因素的,需要全面的管理策略.
- 最佳管理需要控制疾病活动,尽量减少葡萄糖皮质类药物,并使用抗骨质疏松症治疗.
- 包括生活方式建议和跌倒预防在内的多模式方法对于改善iRMD患者的骨健康至关重要.
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