Ohta Hiroaki
Tokyo Women's Medical University, Department of Obstetrics and Gynecology.
Clin Calcium. 2008 Aug;18(8):1096-103.
Now that the goal of osteoporosis management has been clearly defined as prevention of osteoporosis-associated fractures, prevention strategy for these fractures becomes compellingly important. While the new management guideline for osteoporosis places an overriding emphasis on the prevention of osteoporosis, it goes on to stress the importance of pharmacological therapy even in patients at high risk of developing fractures, in whom pharmacological therapy would not be indicated in the earlier guideline, thus recommending that pharmacological therapy be extended to a larger proportion of patients who may benefit from such treatment. In this therapeutic strategy, not only pharmacological therapy in middle-aged and elderly individuals in perimenopause will be of vital importance, as in the earlier guideline, but also non-pharmacological intervention through modification of everyday lifestyle habits will become increasingly important in adolescents and young female adults in their developmental years. It is thus hoped that adherence to the new guideline will lead to a decrease in the frequency of reported fractures, including femoral neck fractures, in Japan.
既然骨质疏松症管理的目标已明确界定为预防与骨质疏松症相关的骨折,那么这些骨折的预防策略就变得极为重要。虽然新的骨质疏松症管理指南将首要重点放在预防骨质疏松症上,但它接着强调了药物治疗的重要性,即便对于骨折高风险患者也是如此,而在早期指南中这些患者并不适用药物治疗,因此建议将药物治疗扩展至更多可能从这种治疗中获益的患者。在这一治疗策略中,不仅如早期指南那样,围绝经期中老年个体的药物治疗至关重要,而且在发育阶段的青少年和年轻成年女性中,通过改变日常生活习惯进行的非药物干预也将变得越来越重要。因此,希望遵循新指南将使日本报告的骨折发生率降低,包括股骨颈骨折。