Cheung Elaine Y N, Tan Kathryn C B, Cheung Ching-Lung, Kung Annie W C
Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China.
Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
Osteoporos Sarcopenia. 2016 Sep;2(3):118-133. doi: 10.1016/j.afos.2016.07.001. Epub 2016 Jul 30.
The greatest burden of hip fractures around the world is expected to occur in East Asia, especially China. However, there is a relative paucity of information on the epidemiology and burden of fractures in East Asia. Osteoporosis is greatly under-diagnosed and under-treated, even among the highest-risk subjects who have already suffered fractures. The accessibility to bone densitometry, the awareness of the disease by professionals and the public, and the use and reimbursement of drugs are some of the areas which need improvement especially. Cost-effective analysis on screening strategy and intervention thresholds based on local epidemiology data and economic status are available only in Japan. In addition, clinical risk factor models for the assessment of fracture probability may be ethnic specific. Further research is needed to develop a cost-effective risk assessment strategy to identify high-risk individuals for screening and treatment based on local data. Moreover, inadequate calcium and vitamin D intake is still an issue faced by this region.
预计全球髋部骨折的最大负担将出现在东亚地区，尤其是中国。然而，关于东亚地区骨折的流行病学和负担的信息相对较少。骨质疏松症的诊断和治疗严重不足，即使在已经发生骨折的高危人群中也是如此。骨密度测定的可及性、专业人员和公众对该疾病的认识以及药物的使用和报销等方面尤其需要改进。目前只有日本有基于当地流行病学数据和经济状况的筛查策略和干预阈值的成本效益分析。此外，用于评估骨折概率的临床风险因素模型可能因种族而异。需要进一步开展研究，以制定一种具有成本效益的风险评估策略，根据当地数据识别需要筛查和治疗的高危个体。此外，钙和维生素D摄入不足仍是该地区面临的一个问题。
