Cianferotti Luisella, Brandi Maria Luisa
Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Clin Cases Miner Bone Metab. 2012 Sep;9(3):170-8. Epub 2012 Dec 20.
Osteoporosis poses a significant public health issue. In recent years, International and National Societies have developed Guidelines for the diagnosis and treatment of this disorder, with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Società Italiana dell'Osteoporosi, del Metabolismo Minerale e delle Malattie dello Scheletro (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, risk-assessment, prevention and management of idiopathic postmenopausal osteoporosis, also focusing on male and secondary osteoporosis. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. Nonetheless, the practical management of osteoporosis is greatly influenced by economic reimbursement policies, particularly for secondary forms of osteoporosis. The refinement of risk assessment, the long-term treatment of osteoporosis and the prevention and management of disease-associated bone loss constitute open issues.
骨质疏松症是一个重大的公共卫生问题。近年来，国际和国家学会制定了该疾病的诊断和治疗指南，致力于根据特定人群的独特特征调整风险评估的具体工具。意大利骨质疏松症、矿物质代谢与骨骼疾病学会（SIOMMMS）最近修订了先前发布的关于特发性绝经后骨质疏松症的诊断、风险评估、预防和管理的指南，同时也关注男性和继发性骨质疏松症。这些建议基于对现有最佳证据的系统评价以及对成本效益的明确考量。当证据有限时，建议基于顶尖专家的经验和意见以及良好的临床实践。尽管如此，骨质疏松症的实际管理很大程度上受到经济报销政策的影响，尤其是对于继发性骨质疏松症。风险评估的细化、骨质疏松症的长期治疗以及疾病相关骨质流失的预防和管理仍是有待解决的问题。
