Yamauchi Mika
Internal Medicine 1, Shimane University Faculty of Medicine, Japan.
Clin Calcium. 2014 May;24(5):733-42.
The risk of osteoporotic fracture is greater in patients with lifestyle-related diseases such as poorly controlled type 2 diabetes mellitus and stage G3 chronic kidney disease (CKD). The Japanese 2011 Guidelines for the Prevention and Treatment of Osteoporosis covered osteoporosis secondary to lifestyle-related diseases as a typical example of secondary osteoporosis, but specific treatment methods for osteoporosis secondary to lifestyle-related diseases have yet to be established. Therefore, treatment currently follows the clinical guidelines for primary osteoporosis. However, reduced bone quality is common in osteoporosis secondary to lifestyle-related diseases and therapeutic intervention should be considered even in patients without bone fracture if bone density is less than 80% that of the young adult mean. It is generally considered that the effectiveness and safety of bisphosphonate and selective estrogen receptor modulators for patients with osteoporosis and type 2 diabetes mellitus or stage G3 CKD are equivalent to those for patients without such lifestyle-related diseases.
在患有与生活方式相关疾病（如2型糖尿病控制不佳和G3期慢性肾脏病（CKD））的患者中，骨质疏松性骨折的风险更高。日本2011年骨质疏松症防治指南将继发于与生活方式相关疾病的骨质疏松症作为继发性骨质疏松症的典型例子，但继发于与生活方式相关疾病的骨质疏松症的具体治疗方法尚未确立。因此，目前的治疗遵循原发性骨质疏松症的临床指南。然而，继发于与生活方式相关疾病的骨质疏松症中骨质量降低很常见，即使在没有骨折的患者中，如果骨密度低于年轻成年人平均值的80%，也应考虑进行治疗干预。一般认为，双膦酸盐和选择性雌激素受体调节剂对患有骨质疏松症和2型糖尿病或G3期CKD患者的有效性和安全性与没有此类与生活方式相关疾病的患者相当。
