Iki Masayuki
Kinki University School of Medicine, Department of Public Health.
Clin Calcium. 2007 Jul;17(7):1015-21.
Goal for management of osteoporosis is prevention of fractures, although the diagnosis of osteoporosis is made according to bone mineral density (BMD) which plays a great role in monitoring the effectiveness of treatment. However, there are many countries and regions where BMD measurement is not available in primary health care. Even if it is available, BMD shows limited validity in predicting fracture risk. A research group of the World Health Organization (WHO) has developed absolute risk assessment models for fracture incorporating several clinical risk factors with and without BMD. The present paper described the outline of these models and addressed several issues when applying these models to the primary medical care and preventive practice in Japan.
骨质疏松症管理的目标是预防骨折,尽管骨质疏松症的诊断是根据骨密度(BMD)做出的,骨密度在监测治疗效果方面起着重要作用。然而,在许多国家和地区,初级卫生保健中无法进行骨密度测量。即使可以进行测量,骨密度在预测骨折风险方面的有效性也有限。世界卫生组织(WHO)的一个研究小组开发了结合了有无骨密度的多种临床风险因素的骨折绝对风险评估模型。本文介绍了这些模型的概况,并讨论了将这些模型应用于日本初级医疗保健和预防实践时的几个问题。