Division of Endocrinology, Department of Medicine, Columbia University Medical Center, Columbia University, College of Physicians & Surgeons, PH8-864, 630 West 168th Street, New York, NY 10032, USA.
Endocrinol Metab Clin North Am. 2017 Mar;46(1):117-133. doi: 10.1016/j.ecl.2016.09.007. Epub 2016 Nov 24.
Most premenopausal women with low trauma fracture(s) or low bone mineral density have a secondary cause of osteoporosis or bone loss. Where possible, treatment of the underlying cause should be the focus of management. Premenopausal women with an ongoing cause of bone loss and those who have had, or continue to have, low trauma fractures may require pharmacologic intervention. Clinical trials provide evidence of benefits of bisphosphonates and teriparatide for bone mineral density in several types of premenopausal osteoporosis, but studies are small and do not provide evidence regarding fracture risk reduction.
大多数绝经前女性,若出现低创伤性骨折或低骨密度,其骨质疏松症或骨质流失的病因可能是继发性的。在可能的情况下,应将潜在病因的治疗作为管理的重点。对于持续存在骨质流失的绝经前女性,以及已经发生过低创伤性骨折或仍在发生骨折的女性,可能需要药物干预。临床试验为几种类型的绝经前骨质疏松症中双磷酸盐和特立帕肽对骨密度的益处提供了证据,但这些研究规模较小,没有提供关于降低骨折风险的证据。