Waugh E J, Lam M-A, Hawker G A, McGowan J, Papaioannou A, Cheung A M, Hodsman A B, Leslie W D, Siminoski K, Jamal S A
Osteoporosis Research Program, Women's College Hospital, Toronto, ON, Canada.
Osteoporos Int. 2009 Jan;20(1):1-21. doi: 10.1007/s00198-008-0643-x. Epub 2008 Jun 4.
Based on a systematic review of the literature, only low body weight and menopausal status can be considered with confidence, as important risk factors for low BMD in healthy 40-60 year old women. The use of body weight to identify high risk women may reduce unnecessary BMD testing in this age group.
BMD testing of perimenopausal women is increasing but may be unnecessary as fracture risk is low. Appropriate assessment among younger women requires identification of risk factors for low BMD specific to this population.
We conducted a systematic literature review of risk factors for low BMD in healthy women aged 40-60 years. Articles were retrieved from six databases and reviewed for eligibility and methodological quality. A grade for overall strength of evidence for each risk factor was assigned.
There was good evidence that low body weight and post-menopausal status are risk factors for low BMD. There was good or fair evidence that alcohol and caffeine intake, and reproductive history are not risk factors. There was inconsistent or insufficient evidence for the effect of calcium intake, physical activity, smoking, age at menarche, history of amenorrhea, family history of OP, race and current age on BMD.
Based on current evidence in Caucasians, we suggest that, in healthy women aged 40-60 years, only those with a low body weight (< 70 kg) be selected for BMD testing. Further research is necessary to determine optimal race-specific discriminatory weight cut-offs and to evaluate the risk factors for which there was inconclusive evidence.
基于对文献的系统综述，在健康的40 - 60岁女性中，只有低体重和绝经状态可被确定为低骨密度的重要风险因素。使用体重来识别高危女性可能会减少该年龄组不必要的骨密度检测。
围绝经期女性的骨密度检测正在增加，但由于骨折风险较低，可能并无必要。对年轻女性进行适当评估需要识别该人群特有的低骨密度风险因素。
我们对40 - 60岁健康女性低骨密度的风险因素进行了系统的文献综述。从六个数据库检索文章，并对其资格和方法学质量进行审查。为每个风险因素的总体证据强度评定等级。
有充分证据表明低体重和绝经后状态是低骨密度的风险因素。有充分或中等证据表明酒精和咖啡因摄入量以及生殖史不是风险因素。关于钙摄入量、身体活动、吸烟、初潮年龄、闭经史、骨质疏松家族史、种族和当前年龄对骨密度的影响，证据不一致或不足。
基于目前对白种人的证据，我们建议，在40 - 60岁的健康女性中，仅选择那些体重低（< 70 kg）的女性进行骨密度检测。有必要进一步研究以确定针对不同种族的最佳区分体重临界值，并评估证据尚无定论的风险因素。
