Boschitsch E P, Durchschlag E, Dimai H P
a Ambulatorium Klimax, Menopause and Osteoporosis Clinic , Vienna , Austria.
b Amgen GmbH , Vienna , Austria.
Climacteric. 2017 Apr;20(2):157-163. doi: 10.1080/13697137.2017.1282452. Epub 2017 Feb 8.
Age and bone mineral density (BMD) are the most relevant determinants for public health authorities to govern the management of osteoporosis. The objectives of this study were to determine the age-related prevalence of osteopenia and osteoporosis according to WHO criteria and fragility fractures in middle-aged and older women.
Women ≥40 years, who were referred to a menopause and osteoporosis outpatient clinic for BMD measurements, were assessed for patient characteristics, BMD and previous fragility fractures of the hip, the distal forearm and the vertebrae. Only records of their initial consultations were used for data analysis.
Between 1990 and 2012, 99,399 women, mean age 56.1 years, were referred to the clinic for BMD testing. Of the total population, 52.5% showed normal, 34.0% osteopenic and 13.5% osteoporotic BMD. Fragility fractures were reported by 6540 patients, with 3070 (47%) non-vertebral fractures, namely 2518 (38.5%) distal forearm and 552 (8.4%) hip fractures; 66.8% of patients with the non-vertebral fractures were <65 years.
The prevalence of osteoporosis and fragility fractures in middle-aged women, < 65 years, is hitherto under-recognized. Measuring BMD alone is not sufficient to identify patients at risk for fractures. Supplemental screening for clinical risk factors already during perimenopause may be advantageous.
年龄和骨密度（BMD）是公共卫生当局管理骨质疏松症的最相关决定因素。本研究的目的是根据世界卫生组织标准确定中年及老年女性中骨量减少和骨质疏松症的年龄相关患病率以及脆性骨折情况。
对年龄≥40岁、因骨密度测量而被转诊至更年期和骨质疏松门诊的女性进行患者特征、骨密度以及既往髋部、远端前臂和脊椎脆性骨折情况的评估。仅使用她们初次就诊记录进行数据分析。
1990年至2012年间，99399名平均年龄为56.1岁的女性被转诊至该门诊进行骨密度检测。在全部人群中，52.5%骨密度正常，34.0%骨量减少，13.5%骨质疏松。6540名患者报告有脆性骨折，其中3070例（47%）为非椎体骨折，即2518例（38.5%）远端前臂骨折和552例（8.4%）髋部骨折；66.8%的非椎体骨折患者年龄<65岁。
65岁以下中年女性中骨质疏松症和脆性骨折的患病率迄今未得到充分认识。仅测量骨密度不足以识别骨折风险患者。在围绝经期就对临床风险因素进行补充筛查可能是有益的。
