Endocr Pract. 2020 May;26(Suppl 1):1-46. doi: 10.4158/GL-2020-0524SUPPL.
The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols. The Executive Summary of this 2020 updated guideline contains 52 recommendations: 21 Grade A (40%), 24 Grade B (46%), 7 Grade C (14%), and no Grade D (0%). These detailed, evidence-based recommendations allow for nuance-based clinical decision-making that addresses multiple aspects of real-world care of patients. The evidence base presented in the subsequent Appendix provides relevant supporting information for the Executive Summary recommendations. This update contains 368 citations: 123 (33.5%) evidence level (EL) 1 (highest), 132 (36%) EL 2 (intermediate), 20 (5.5%) EL 3 (weak), and 93 (25%) EL 4 (lowest). New or updated topics in this CPG include: clarification of the diagnosis of osteoporosis, stratification of the patient according to high-risk and very-high-risk features, a new dual-action therapy option, and transitions from therapeutic options. This guideline is a practical tool for endocrinologists, physicians in general, regulatory bodies, health-related organizations, and interested laypersons regarding the diagnosis, evaluation, and treatment of post-menopausal osteoporosis. = 25-hydroxyvitamin D; = American Association of Clinical Endocrinologists; = American College of Endocrinology; = atypical femoral fracture; = American Society for Bone and Mineral Research; = best evidence level; = bone mineral density; = bone turnover marker; = confidence interval; = clinical practice guideline; = C-terminal telopeptide type-I collagen; = dual-energy X-ray absorptiometry; = evidence level; = U.S. Food and Drug Administration; = Fracture Risk Assessment Tool; = gastrointestinal; = Health Outcomes and Reduced Incidence with Zoledronic acid ONce yearly Pivotal Fracture Trial (zoledronic acid and zoledronate are equivalent terms); = International Society for Clinical Densitometry; = international units; = intravenous; = least significant change; = National Osteoporosis Foundation; = osteonecrosis of the jaw; = serum amino-terminal propeptide of type-I collagen; = parathyroid hormone; = recommendation; = region of interest; = relative risk; = standard deviation; = trabecular bone score; = vertebral fracture assessment; = World Health Organization.
这些指南的制定得到了美国临床内分泌医师协会（AACE）董事会和美国内分泌学会（ACE）董事会的赞助，并遵循了已发表的 AACE/ACE 临床实践指南（CPG）标准化生产协议。建议是根据对临床证据的认真审查，并根据既定的 AACE/ACE 指南协议透明地纳入主观因素得出的。本 2020 年更新指南的执行摘要包含 52 条建议：21 条 A 级（40%），24 条 B 级（46%），7 条 C 级（14%），无 D 级（0%）。这些详细的、基于证据的建议允许基于细微差别的临床决策，解决患者实际护理的多个方面。随后附录中提供的证据基础为执行摘要建议提供了相关支持信息。本次更新包含 368 条引用：123 条（33.5%）证据级别（EL）1（最高），132 条（36%）EL 2（中级），20 条（5.5%）EL 3（弱），93 条（25%）EL 4（最低）。该 CPG 中的新或更新主题包括：骨质疏松症诊断的澄清，根据高危和极高危特征对患者进行分层，新的双作用治疗选择，以及治疗选择的转变。本指南是内分泌学家、一般医生、监管机构、与健康相关的组织以及对此感兴趣的非专业人士在绝经后骨质疏松症的诊断、评估和治疗方面的实用工具。 = 25-羟维生素 D； = 美国临床内分泌医师协会； = 美国内分泌学会； = 非典型股骨骨折； = 美国骨与矿物质研究学会； = 最佳证据水平； = 骨密度； = 骨转换标志物； = 置信区间； = 临床实践指南； = I 型胶原 C 端肽； = 双能 X 射线吸收法； = 证据水平； = 美国食品和药物管理局； = 骨折风险评估工具； = 胃肠道； = 唑来膦酸每年一次关键性骨折试验的健康结果和减少发生率（唑来膦酸和唑来膦酸盐是等效术语）； = 国际临床密度测定学会； = 国际单位； = 静脉内； = 最小有意义变化； = 国家骨质疏松基金会； = 下颌骨坏死； = I 型胶原氨基端前肽； = 甲状旁腺激素； = 建议； = 感兴趣区； = 相对风险； = 标准差； = 小梁骨评分； = 椎体骨折评估； = 世界卫生组织。
