Matikainen Niina
Duodecim. 2016;132(11):1051-8.
Osteoporosis is defined by decreased bone density and microarchitectural deterioration that predispose to fragility fractures. The WHO diagnostic criteria of osteoporosis require bone densitometry but treatment is possible on the basis of high clinical fracture risk and can be assessed by the FRAX risk algorithm. All those subject to fracture risk should be advised about proper basic treatment of osteoporosis, including exercise, prevention of falls, smoking cessation, avoidance of alcohol intake, and dietary or supplemental abundance of calcium and vitamin D. Underlying diseases must be studied after diagnosis of osteoporosis even if treatment is initiated without densitometry. When indicated, specific osteoporosis therapy includes bisphosphonates, denosumab, teriparatide, strontium ranelate or SERMs. In hypogonadism, gonadal steroids may be indicated alone or in addition to a specific treatment. Treatment effect and continuation are assessed after 2 to 5 years.
骨质疏松症的定义是骨密度降低和微观结构恶化，从而易发生脆性骨折。世界卫生组织的骨质疏松症诊断标准需要进行骨密度测量，但基于高临床骨折风险也可以进行治疗，并且可以通过FRAX风险算法进行评估。所有有骨折风险的人都应被告知有关骨质疏松症的适当基础治疗，包括运动、预防跌倒、戒烟、避免饮酒以及饮食中或补充充足的钙和维生素D。即使在未进行骨密度测量就开始治疗的情况下，骨质疏松症诊断后也必须研究潜在疾病。如有指征，特定的骨质疏松症治疗包括双膦酸盐、地诺单抗、特立帕肽、雷奈酸锶或选择性雌激素受体调节剂。在性腺功能减退时，性腺类固醇可能单独使用或作为特定治疗的补充。2至5年后评估治疗效果和是否继续治疗。
