Sowers M F
School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Jun;14(2):317-29. doi: 10.1053/beem.2000.0076.
There is evidence that two-thirds of the risk of osteoporotic fracture can be predicted from the pre-menopausal bone mineral density. The frequency of osteoporosis in older women may be modifiable by implementing invention strategies in the pre- and peri-menopausal periods. Lower peak bone mineral density and bone loss can be identified in women with altered reproductive hormone or calciotrophic hormone concentrations, or selected lifestyle practices. Alterations in reproductive hormones may occur in adolescence (from an early age of pregnancy or the amenorrhoea of anorexia nervosa or exercise), in the pre-menopause (nulliparity, oophorectomy, early ovarian failure or marginal hormonal status) or in the peri-menopause. Alterations in calciotrophic hormone concentrations include corticosteroid therapy and breast cancer treatment. Lifestyle risk factors include the misuse of alcohol and possibly smoking, physical inactivity or an imbalance in dietary intake. Effective intervention currently consists of treating underlying conditions and monitoring high-risk groups.
有证据表明，骨质疏松性骨折三分之二的风险可根据绝经前的骨矿物质密度预测。通过在绝经前和围绝经期实施干预策略，老年女性骨质疏松症的发生率可能会得到改善。生殖激素或钙营养激素浓度改变或特定生活方式的女性，可出现较低的骨峰值密度和骨质流失。生殖激素的改变可能发生在青春期（因早孕、神经性厌食症闭经或运动）、绝经前（未生育、卵巢切除术、卵巢早衰或激素水平临界状态）或围绝经期。钙营养激素浓度的改变包括皮质类固醇治疗和乳腺癌治疗。生活方式风险因素包括酗酒、可能还有吸烟、缺乏身体活动或饮食摄入不均衡。目前有效的干预措施包括治疗潜在疾病和监测高危人群。
