Department of Endocrinology, Post Graduate Institute Of Medical Education and Research, Chandigarh, 160012, India.
Department of Endocrinology, Parmanand Deepchand Hinduja Hospital, Mumbai, 400016, India.
Arch Osteoporos. 2021 Jun 26;16(1):102. doi: 10.1007/s11657-021-00954-1.
The Indian Society for Bone and Mineral Research (ISBMR) has herein drafted clinical practice guidelines for the diagnosis and management of osteoporosis for the people of India. Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.
In India, osteoporosis is a major public health problem. However, in the absence of any robust regional guidelines, the screening, treatment, and follow-up of patients with osteoporosis are lagging behind in the country.
The Indian Society for Bone and Mineral Research (ISBMR), which is a multidisciplinary group of physicians, researchers, dietitians, and epidemiologists and who study bone and related tissues, in their annual meeting, drafted the guidelines for the diagnosis and management of osteoporosis that would be appropriate in a resource constraint setting like India.
Diagnosis of osteoporosis can be made in a patient with minimal trauma fracture without the aid of any other diagnostic tools. In others, bone mineral density measured by dual-energy X-ray absorptiometry remains the modality of choice. Data indicates that osteoporotic fractures occur at an earlier age in Indians than in the West; hence, screening for osteoporosis should begin at an earlier age. FRAX can be used for fracture risk estimation; however, it may underestimate the risk of future fractures in our population and still needs validation. Maintaining optimum serum 25-hydroxyvitamin D levels is essential, which, in most cases, would require regular vitamin D supplementation. Pharmacotherapy should be guided by the presence/absence of vertebral/hip fractures or the severity of risk based on clinical factors, although bisphosphonates remain the first choice in most cases. Regular follow-up is essential to ensure adherence and response to therapy.
Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.
印度骨与矿物质研究学会（ISBMR）在此为印度人民制定了骨质疏松症的诊断和管理临床实践指南。预计在临床实践中实施该立场声明将改善印度骨质疏松症患者的整体护理。
在印度，骨质疏松症是一个主要的公共卫生问题。然而，由于缺乏任何强有力的区域指南，该国的骨质疏松症患者的筛查、治疗和随访都滞后。
印度骨与矿物质研究学会（ISBMR）是一个由医生、研究人员、营养师和流行病学家组成的多学科团体，研究骨骼和相关组织。在年会上，他们制定了适合印度这样的资源有限环境的骨质疏松症诊断和管理指南。
可以在没有任何其他诊断工具的情况下，通过轻微创伤性骨折的患者做出骨质疏松症的诊断。在其他患者中，双能 X 射线吸收法测量的骨矿物质密度仍然是首选方法。数据表明，印度人的骨质疏松性骨折发生年龄比西方早；因此，应更早开始筛查骨质疏松症。FRAX 可用于骨折风险估计；然而，它可能低估了我们人群中未来骨折的风险，仍需要验证。保持最佳血清 25-羟维生素 D 水平至关重要，在大多数情况下，这需要定期补充维生素 D。药物治疗应根据是否存在椎体/髋部骨折或基于临床因素的风险严重程度来指导，尽管在大多数情况下双磷酸盐仍然是首选药物。定期随访对于确保治疗的依从性和反应至关重要。
预计在临床实践中实施该立场声明将改善印度骨质疏松症患者的整体护理。
