Nakamura Toshitaka
University of Occupational and Environmental Health, Department of Orthopedic Surgery.
Clin Calcium. 2007 Jul;17(7):1022-8.
Bone mineral density (BMD) is a strong predictor of osteoporotic fractures. However, the increase in fracture risk is not steep, rather gentle, for the decline in BMD values. Postmenopausal women with osteopenia (T scores between - 2.5 and - 1.0) may also be at risk. Case finding strategies such as the combination of BMD and appropriate clinical risk factors for fracture are shown to identify subjects at high fracture risk. World Health Organization developed a fracture risk assessment tool, recommending its exploitation in the case findings. Under these circumstances, Japan guideline 2006 provided new criteria for the pharmacological intervention to prevent fragility fracture, besides the conventional criteria for diagnosing osteoporosis.
骨密度(BMD)是骨质疏松性骨折的有力预测指标。然而,随着BMD值的下降,骨折风险的增加并不陡峭,而是较为平缓。骨量减少(T值在-2.5至-1.0之间)的绝经后女性也可能面临风险。诸如将BMD与适当的骨折临床风险因素相结合的病例发现策略,已被证明可识别出骨折高风险人群。世界卫生组织开发了一种骨折风险评估工具,并建议在病例发现中加以应用。在这种情况下,日本2006年指南除了给出诊断骨质疏松症的传统标准外,还提供了预防脆性骨折的药物干预新标准。