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妇科医生的骨骼健康

Bone Health for Gynaecologists.

作者信息

Yordanov Angel, Vasileva-Slaveva Mariela, Tsoneva Eva, Kostov Stoyan, Yanachkova Vesselina

机构信息

Department of Gynecologic Oncology, Medical University-Pleven, 5800 Pleven, Bulgaria.

Research Institute, Medica University Pleven, 5800 Pleven, Bulgaria.

出版信息

Medicina (Kaunas). 2025 Mar 18;61(3):530. doi: 10.3390/medicina61030530.

Abstract

Osteoporosis, the most common bone disorder, profoundly impacts women's health, especially during postmenopausal phases. Characterised by diminished bone mineral density (BMD), it increases the risk of fractures, affecting mobility, quality of life, and potentially mortality. The present review analyses the intricate interactions among physiological alterations, diseases, and medications that lead to bone mineral density reduction in women. It underscores the importance of gynaecologists in the prevention, diagnosis, and management of osteoporosis via early risk assessment, suitable hormone treatment, and lifestyle modifications. Essential considerations encompass the categorisation of osteoporosis into primary (age-related) and secondary (attributable to diseases or pharmacological treatments) types, with particular emphasis on predisposing conditions such as premature menopause, hormone deficits, and cancer therapies. The significance of diagnostic instruments such as DXA and novel methodologies like trabecular bone score and quantitative ultrasonography is emphasised for precise evaluation and surveillance. The review also addresses nutritional methods, physical exercise, and pharmaceutical interventions, including hormone replacement therapy (HRT), selective oestrogen receptor modulators (SERMs), and other anti-resorptive drugs, to preserve bone health. This review highlights the important role of gynaecologists in maintaining women's bone health, promoting a proactive strategy to avert osteoporosis-related complications and enhance long-term results.

摘要

骨质疏松症是最常见的骨骼疾病,对女性健康有深远影响,尤其是在绝经后阶段。其特征为骨矿物质密度(BMD)降低,会增加骨折风险,影响行动能力、生活质量,甚至可能导致死亡。本综述分析了导致女性骨矿物质密度降低的生理改变、疾病和药物之间的复杂相互作用。强调了妇科医生通过早期风险评估、适当的激素治疗和生活方式调整,在骨质疏松症的预防、诊断和管理中的重要性。重要考虑因素包括将骨质疏松症分为原发性(与年龄相关)和继发性(归因于疾病或药物治疗)类型,特别强调诸如过早绝经、激素缺乏和癌症治疗等易感因素。强调了双能X线吸收法(DXA)等诊断工具以及小梁骨评分和定量超声等新方法在精确评估和监测中的重要性。该综述还探讨了营养方法、体育锻炼和药物干预措施,包括激素替代疗法(HRT)、选择性雌激素受体调节剂(SERM)和其他抗吸收药物,以维护骨骼健康。本综述强调了妇科医生在维持女性骨骼健康方面的重要作用,倡导采取积极策略以避免骨质疏松症相关并发症并提高长期效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ea8/11944197/b3af1e72da05/medicina-61-00530-g001.jpg

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