Bonnick Sydney L
Department of Biology, University of North Texas Denton, TX 76210, USA.
Clin Cornerstone. 2006;8(1):28-39. doi: 10.1016/s1098-3597(06)80063-3.
Osteoporosis is a cause of significant morbidity and mortality in postmenopausal women as well as men. In both men and women, increasing age and low bone mineral density (BMD) are the 2 most important independent risk factors for an initial vertebral or nonvertebral fracture. Although the prevalence of osteoporosis is greater in women, mortality after fracture is higher among men. In both men and women, the incidence of vertebral fracture increases with age, although the increase is more marked in women than in men. The diagnostic criteria for postmenopausal osteoporosis in women are well established; however, there is ongoing debate about the appropriate T-scores and BMD thresholds to diagnose osteoporosis in men. Alendronate and risedronate are considered first-line therapy for the treatment of both postmenopausal osteoporosis and male osteoporosis. The efficacy and safety of these agents have been evaluated extensively in randomized clinical trials. Studies suggest that these agents are similarly efficacious in men and women. The anabolic agent teriparatide may also be used to treat men with osteoporosis at high risk for fracture. Studies suggest that treatment with an anabolic agent like teriparatide should be followed by an antiresorptive agent.
骨质疏松症是绝经后女性以及男性发病和死亡的重要原因。在男性和女性中，年龄增长和低骨密度（BMD）是初次发生椎体或非椎体骨折的两个最重要的独立危险因素。尽管女性骨质疏松症的患病率更高，但骨折后的死亡率在男性中更高。在男性和女性中，椎体骨折的发生率均随年龄增长而增加，不过女性的增加更为明显。女性绝经后骨质疏松症的诊断标准已明确确立；然而，对于诊断男性骨质疏松症的合适T值和BMD阈值仍存在争议。阿仑膦酸盐和利塞膦酸盐被视为治疗绝经后骨质疏松症和男性骨质疏松症的一线疗法。这些药物的疗效和安全性已在随机临床试验中得到广泛评估。研究表明，这些药物在男性和女性中疗效相似。促合成代谢药物特立帕肽也可用于治疗骨折高危的男性骨质疏松症患者。研究表明，使用特立帕肽等促合成代谢药物治疗后应继以抗吸收药物。
