Gronholz M Jill
Bone Density of North Idaho, 920 Ironwood Dr, Coeur d'Alene, ID 83814-2463, USA.
J Am Osteopath Assoc. 2008 Oct;108(10):575-85.
In the United States, approximately 30 million women and 10 million men aged 50 years or older have osteoporosis, low bone mineral density, or both, placing them at risk for disabling fractures. Despite the high prevalence and serious medical consequences of osteoporosis, many at-risk patients are inadequately screened and diagnosed before symptomatic fractures occur. Osteopathic physicians are in a unique position to promote a multifactoral approach to patient evaluation, disease prevention, and treatment. The author evaluates aspects of such an approach through a review of the literature. A number of screening tools based on easily assessed factors are available to identify at-risk patients. Interventions for fracture reduction should include nonpharmacologic strategies such as risk factor modification, nutrition guidance and dietary supplementation, physical exercise, and osteopathic manipulative treatment. Pharmacologic intervention should be considered for patients with low bone mineral density as well as those who have sustained vertebral or hip fracture. A holistic multifactoral assessment and intervention strategy are recommended to reduce substantially the risk of fracture and to improve long-term patient outcomes.
在美国，约3000万50岁及以上的女性和1000万50岁及以上的男性患有骨质疏松症、骨矿物质密度低或两者兼有，这使他们面临致残性骨折的风险。尽管骨质疏松症患病率高且具有严重的医学后果，但许多高危患者在出现症状性骨折之前未得到充分筛查和诊断。整骨医师在促进采用多因素方法进行患者评估、疾病预防和治疗方面具有独特地位。作者通过文献综述评估了这种方法的各个方面。有多种基于易于评估因素的筛查工具可用于识别高危患者。减少骨折的干预措施应包括非药物策略，如危险因素修正、营养指导和膳食补充、体育锻炼以及整骨手法治疗。对于骨矿物质密度低以及发生过椎体或髋部骨折的患者，应考虑药物干预。建议采用全面的多因素评估和干预策略，以大幅降低骨折风险并改善患者长期预后。
