Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, 1211 Geneva 14, Switzerland.
Best Pract Res Clin Endocrinol Metab. 2018 Oct;32(5):739-757. doi: 10.1016/j.beem.2018.09.005. Epub 2018 Sep 22.
Osteoporosis increases the risk of fractures, which are associated with increased mortality and lower quality of life. Patients with prevalent fracture are at high risk to of sustaining another one. Optimal protein and calcium intakes, and vitamin D supplies, together with regular weight bearing physical exercise are the corner stones of fracture prevention. Evidence for anti-fracture efficacy of pharmacological interventions relies on results from randomised controlled trials in postmenopausal women with fractures as the primary outcome. Treatments with bone resorption inhibitors, like bisphosphonates or denosumab, and bone formation stimulator like teriparatide, reduce vertebral and non-vertebral fracture risk. A reduction in vertebral fracture risk can already be detected within a year after starting therapy.
骨质疏松症增加了骨折的风险，而骨折与死亡率增加和生活质量降低有关。患有骨折的患者有很高的再次骨折的风险。最佳的蛋白质和钙摄入量以及维生素 D 供应，加上定期的负重体育锻炼，是预防骨折的基石。药物干预抗骨折疗效的证据依赖于绝经后妇女骨折为主要结局的随机对照试验的结果。骨吸收抑制剂（如双膦酸盐或地舒单抗）和骨形成刺激剂（如特立帕肽）的治疗可降低椎体和非椎体骨折的风险。在开始治疗后一年内就可以检测到椎体骨折风险的降低。
