骨质疏松症:骨折预防的一个关键目标
Ian R Reid1, Michael R McClung2
1Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
The lancet. Diabetes & endocrinology
|September 26, 2024
概括
骨质疏松症的特征是骨矿物质密度 (BMD) 低,影响了许多老年人. 虽然不总是表明立即干预,但骨质量评估对于计算骨折风险至关重要,指导骨健康的治疗决策.
科学领域:
- 老年学是一门学科.
- 骨的新陈代谢 骨的新陈代谢
- 放射学 放射学是一门学科.
背景情况:
- 骨质疏松症最初是指骨密度下降的定性放射学术语.
- 自1994年以来,骨质疏松症的定量定义是骨矿物质密度 (BMD) T-score在-1.0和-2.5之间.
- 超过60%的64岁以上的白人女性患有骨质疏松症,这代表了一个重要的人口统计数据.
研究的目的:
- 审查有关老年人诊断患有骨折性骨密度的管理的证据.
- 强调骨矿物质密度 (BMD) 在定量骨折风险评估中的作用.
- 评估双酸盐在减少骨折患者骨折的疗效和成本效益.
主要方法:
- 对骨质疏松症管理现有临床试验证据的评估.
- 骨折风险因素在骨折范围内的分析,包括骨质量,年龄和病史.
- 对老年骨质疏松妇女的双酸盐疗法的成本效益评估.
主要成果:
- 大多数骨折发生在骨质疏松的个体中,由于它们的数量很大,尽管与骨质疏松症相比,个体风险较低.
- 骨质疏松症的骨折风险是高度可变的,受BMD,年龄,骨折史和种族的影响.
- 口服和静脉注射双酸盐已在老年骨质疏松妇女中证明具有成本效益的骨折减少.
结论:
- 仅仅诊断骨质疏松症就不足以进行干预或放心;骨质疏松症必须纳入骨折风险计算.
- 10-15%的骨质疏松性骨折风险可能证明65岁以上有动机的个体接受通用双酸盐治疗是合理的.
- 对于患有骨质疏松性骨密度的老年人,管理策略应包括定量骨折风险评估和基于证据的治疗方法.
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