Department of Medicine 1, Holbæk Hospital, DK-4300 Holbæk, Denmark.
OPEN-Open Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, DK-5000 Odense, Denmark.
J Clin Endocrinol Metab. 2023 Oct 18;108(11):e1175-e1185. doi: 10.1210/clinem/dgad256.
Vertebral fractures (VFs) make up an important but challenging group of fractures often caused by osteoporosis. Osteoporotic fractures pose unique diagnostic challenges in generally requiring imaging for diagnosis. The objective of this narrative mini-review is to provide an overview of these recent advances in our knowledge of VF pathophysiology and epidemiology with particular focus on endocrine diseases, prevention, and treatment.
We searched PubMed on May 23, 2022, for studies of VFs in humans. Results were limited to papers available as full-text publications in English, published from 2020 and onward. This yielded 3457 citations. This was supplemented by earlier publications selected to add context to the recent findings.
Studies addressed VF risk in hyperthyreosis, hyperparathyroidism, acromegaly, Cushing syndrome, primary aldosteronism, and diabetes. For pharmaceutical treatment, new studies or analyses were identified for romosozumab and for weekly teriparatide. Several studies, including studies in the immediate pipeline, were intervention studies with vertebroplasty or kyphoplasty, including combination with stem cells or pharmaceuticals.
Endocrinologists should be aware of the high likelihood of osteoporotic VFs in patients with endocrine diseases. Though licensed treatments are able to substantially reduce the occurrence of VFs in patients with osteoporosis, the vast majority of recent or ongoing randomized controlled trials in the VF area focus on advanced invasive therapy of the fracture itself.
椎体骨折（VF）是一组重要但具有挑战性的骨折，通常由骨质疏松症引起。骨质疏松性骨折在诊断上具有独特的挑战，通常需要影像学检查来确诊。本叙述性迷你综述的目的是概述最近在 VF 病理生理学和流行病学方面的知识进展，特别关注内分泌疾病、预防和治疗。
我们于 2022 年 5 月 23 日在 PubMed 上搜索了人类 VF 的研究。结果仅限于可全文获取的英文出版物，且发表时间在 2020 年及以后。共得到 3457 条引文。此外，还选择了更早的出版物来补充近期发现的背景信息。
研究探讨了甲状腺功能亢进、甲状旁腺功能亢进、肢端肥大症、库欣综合征、原发性醛固酮增多症和糖尿病患者的 VF 风险。在药物治疗方面，发现了新的关于罗莫佐单抗和每周特立帕肽的研究或分析。包括与干细胞或药物联合使用的椎体成形术或后凸成形术在内的多项研究，包括干预性研究，均涉及到内分泌疾病患者的骨质疏松性 VF 发生风险。虽然已获得许可的治疗方法能够显著降低骨质疏松症患者 VF 的发生，但最近或正在进行的 VF 领域的绝大多数随机对照试验都集中在骨折本身的先进侵入性治疗上。
