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JAMA. 2018 Jun 26;319(24):2521-2531. doi: 10.1001/jama.2018.7498.

贯穿女性生命周期的改善骨骼健康建议。

Recommendations for Improving Women's Bone Health Throughout the Lifespan.

机构信息

Society for Women's Health Research, Washington, District of Columbia, USA.

出版信息

J Womens Health (Larchmt). 2022 Dec;31(12):1671-1676. doi: 10.1089/jwh.2022.0361. Epub 2022 Nov 7.

DOI:10.1089/jwh.2022.0361
PMID:36346282
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9805882/
Abstract

Osteoporosis is a common condition in which deteriorating bone tissue results in an increased risk of low trauma fracture. Influenced by the role of estrogen in building and maintaining bone mineral density, women have different patterns of bone accrual and loss compared with men, resulting in a lower peak bone mass and a greater lifetime fracture risk. Moreover, fracture risk increases significantly in postmenopausal women who have depleted estrogen levels. Osteoporotic fractures pose serious consequences-ranging from an inability to perform basic tasks and an increased risk of repeat fracture to the need for assisted living and even death. There is also a large economic toll associated with the health care costs required for post-fracture care. The Society for Women's Health Research (SWHR) convened an interdisciplinary Bone Health Working Group to review the current state of science and practice concerning women's bone health and osteoporosis care and to explore strategies to address gaps in screening, diagnosis, and treatment of bone disease in women. Women's bone health care must shift its paradigm from one of postmenopausal and post-fracture care to a preventive model that engages touchpoints throughout the lifespan. To achieve this paradigm shift, the Working Group recommends prioritizing efforts to build public awareness and clinical education of preventive bone health care for women, increase access to screening tools, improve patient-provider communication, and treat osteoporosis using a broader risk stratification approach.

摘要

骨质疏松症是一种常见的疾病,其特征是骨组织恶化导致低创伤性骨折的风险增加。受雌激素在构建和维持骨矿物质密度中的作用影响,女性的骨积累和流失模式与男性不同,导致峰值骨量较低,终生骨折风险较大。此外,雌激素水平耗尽的绝经后妇女的骨折风险显著增加。骨质疏松性骨折会造成严重后果——从无法完成基本任务和增加重复骨折的风险,到需要辅助生活,甚至死亡。与骨折后护理所需的医疗保健费用相关的还有巨大的经济损失。妇女健康研究协会 (SWHR) 召集了一个跨学科的骨骼健康工作组,审查了关于妇女骨骼健康和骨质疏松症护理的现有科学和实践状况,并探讨了解决妇女骨骼疾病筛查、诊断和治疗方面差距的策略。妇女骨骼健康护理必须将其模式从绝经后和骨折后护理转变为一种预防模式,该模式贯穿整个生命周期的各个接触点。为了实现这一模式转变,工作组建议优先努力提高公众对妇女预防骨骼健康护理的认识和临床教育,增加对筛查工具的获取,改善医患沟通,并采用更广泛的风险分层方法治疗骨质疏松症。