Johnston C C, Slemenda C W
Indiana University School of Medicine, Indianapolis 46202.
Exp Gerontol. 1990;25(3-4):297-301. doi: 10.1016/0531-5565(90)90065-a.
The clinical utility of bone mass measurements has been the subject of considerable debate. The determination of whether a measurement has utility in clinical practice is difficult, but several elements must be present. First, the measurement must be predictive of clinical outcomes. Two recent studies have shown that bone mass measurements predict the incidence of both nonspine and vertebral body fractures. A second necessary element is the availability of therapeutic options which would be based on these measurements. The effectiveness of estrogen replacement therapy in preventing bone loss and subsequent fractures is well documented. It is also possible that alterations in glucocorticoid therapy or treatment of hyperparathyroidism might be based on bone measurements. Finally, it should be clear that the information available through bone mass measurements would not be otherwise obtainable. Researchers have yet to demonstrate that other risk fractures are adequate substitutes either in the prediction of bone mass or in the estimations of fracture risk. Although it is not yet clear that bone mass measurements should be used in screening, their clinical utility in specific circumstances is becoming established.
骨量测量的临床实用性一直是大量争论的主题。判断一项测量在临床实践中是否有用是困难的，但必须具备几个要素。首先，该测量必须能够预测临床结果。最近的两项研究表明，骨量测量可预测非脊柱和椎体骨折的发生率。第二个必要要素是要有基于这些测量结果的治疗选择。雌激素替代疗法在预防骨质流失和随后骨折方面的有效性已有充分记录。糖皮质激素疗法的改变或甲状旁腺功能亢进的治疗也有可能基于骨量测量。最后，应该明确的是，通过骨量测量获得的信息是无法通过其他方式获得的。研究人员尚未证明其他骨折风险因素在骨量预测或骨折风险评估中是足够的替代指标。尽管目前尚不清楚骨量测量是否应用于筛查，但它们在特定情况下的临床实用性正在得到确立。
