Toni Stabile Osteoporosis Center and Metabolic Bone Diseases Program, Division of Endocrinology, Department of Medicine, Columbia University Medical Center, 180 Fort Washington Avenue, New York, NY 10032, USA.
Osteoporos Int. 2012 Aug;23(8):2093-7. doi: 10.1007/s00198-012-1991-0. Epub 2012 Apr 28.
Osteoporosis is a skeletal disorder in which reductions in bone strength predispose to an increased risk for fractures. Currently, the diagnosis is officially made based exclusively on bone mineral density T-scores that are ≤-2.5 at the spine or hip. Limiting the clinical diagnosis of osteoporosis solely to a T-score-based criterion, which is the official convention in the USA, creates uncertainty about the use of the term osteoporosis to diagnose older women and men who have T-scores >-2.5, but either have already sustained low-trauma fractures or are recognized as having high fracture risk based on absolute fracture risk calculations from FRAX or other algorithms. A failure to diagnose such patients as having osteoporosis may be one component of the well-documented underdiagnosis and undertreatment of this disease which limits our ability to reduce the burden of fractures worldwide. There is a need to expand the criteria for making a clinical diagnosis and to codify these changes in order to help patients, physicians, policy makers, and payers better understand who has this disease and the elevated risk for fracture that it represents.
骨质疏松症是一种骨骼疾病，其骨强度降低会增加骨折的风险。目前，该疾病的诊断完全基于骨密度 T 评分，当脊柱或臀部的 T 评分≤-2.5 时，即可确诊。仅将骨质疏松症的临床诊断限于基于 T 评分的标准（这是美国的官方惯例），会导致人们对使用该术语来诊断 T 评分＞-2.5 的老年男女产生不确定性，这些人要么已经遭受低创伤性骨折，要么基于 FRAX 或其他算法的绝对骨折风险计算，被认为具有高骨折风险。未能将此类患者诊断为患有骨质疏松症，可能是该疾病诊断不足和治疗不足的一个原因，这限制了我们在全球范围内减少骨折负担的能力。有必要扩大临床诊断标准，并对这些变化进行编码，以帮助患者、医生、政策制定者和支付者更好地了解哪些人患有这种疾病，以及它所代表的骨折风险增加。
